How much rates vary
Facilitymedian $372 · 10th to 90th $35 to $646Professionalmedian $324 · 10th to 90th $41 to $1,000
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $34.67 Median $436.52 Typical High $707.95 | Facility | None | $34.67 | $436.52 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $47.86 Typical High $645.65 | Professional | None | $32.36 | $47.86 | $645.65 |
AllWays Health Partners Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $1,905.46 | Professional | None | $33.11 | $89.13 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $758.58 | Professional | None | $275.42 | $380.19 | $758.58 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $426.58 Median $1,905.46 Typical High $3,801.89 | Professional | None | $426.58 | $1,905.46 | $3,801.89 |
AvMed Setting Professional Modifier None Typical Low $21.38 Median $22.91 Typical High $25.12 | Professional | None | $21.38 | $22.91 | $25.12 |
BCBS Setting Facility Modifier None Typical Low $0.02 Median $34.67 Typical High $48.98 | Facility | None | $0.02 | $34.67 | $48.98 |
BCBS Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $630.96 | Professional | None | $281.84 | $389.05 | $630.96 |
Baylor Scott & White Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $645.65 | Professional | None | $363.08 | $478.63 | $645.65 |
Blue Shield Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $436.52 | Professional | None | $257.04 | $363.08 | $436.52 |
Capital Blue Cross Setting Professional Modifier None Typical Low $269.15 Median $501.19 Typical High $676.08 | Professional | None | $269.15 | $501.19 | $676.08 |
CareFirst Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $5.50 | Professional | None | $3.09 | $3.31 | $5.50 |
CareSource Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $323.59 | Facility | None | $91.20 | $125.89 | $323.59 |
CareSource Setting Professional Modifier None Typical Low $91.20 Median $158.49 Typical High $331.13 | Professional | None | $91.20 | $158.49 | $331.13 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $20.42 Median $25.12 Typical High $190.55 | Professional | None | $20.42 | $25.12 | $190.55 |
Christus Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $831.76 | Professional | None | $309.03 | $446.68 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $144.54 Median $691.83 Typical High $1,047.13 | Professional | None | $144.54 | $691.83 | $1,047.13 |
Contra Costa Health Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $251.19 | Professional | None | $123.03 | $181.97 | $251.19 |
DeanCare Setting Facility Modifier None Typical Low $60.26 Median $74.13 Typical High $120.23 | Facility | None | $60.26 | $74.13 | $120.23 |
DeanCare Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $87.10 | Professional | None | $41.69 | $41.69 | $87.10 |
Denver HMP Setting Facility Modifier None Typical Low $1,905.46 Median $3,388.44 Typical High $3,630.78 | Facility | None | $1,905.46 | $3,388.44 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $57.54 Median $186.21 Typical High $1,174.90 | Professional | None | $57.54 | $186.21 | $1,174.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $501.19 | Professional | None | $117.49 | $141.25 | $501.19 |
Fallon Health Setting Facility Modifier None Typical Low $21.38 Median $30.20 Typical High $5,888.44 | Facility | None | $21.38 | $30.20 | $5,888.44 |
Florida Blue Setting Professional Modifier None Typical Low $19.05 Median $38.02 Typical High $44.67 | Professional | None | $19.05 | $38.02 | $44.67 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $426.58 Typical High $588.84 | Professional | None | $213.80 | $426.58 | $588.84 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | None | $309.03 | $309.03 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $100.00 | Professional | None | $47.86 | $61.66 | $100.00 |
Health Alliance Plan Setting Facility Modifier None Typical Low $398.11 Median $416.87 Typical High $575.44 | Facility | None | $398.11 | $416.87 | $575.44 |
Health Alliance Plan Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $562.34 | Professional | None | $52.48 | $52.48 | $562.34 |
Hometown Health Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $812.83 | Professional | None | $389.05 | $524.81 | $812.83 |
Horizon BCBS Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $870.96 | Professional | None | $398.11 | $426.58 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $870.96 | Professional | None | $263.03 | $426.58 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,905.46 | $1,905.46 | $3,801.89 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $676.08 Typical High $1,000.00 | Professional | None | $245.47 | $676.08 | $1,000.00 |
Martin's Point Setting Facility Modifier None Typical Low $30.20 Median $537.03 Typical High $724.44 | Facility | None | $30.20 | $537.03 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $575.44 | Professional | None | $30.20 | $30.20 | $575.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $33.11 Median $89.13 Typical High $1,905.46 | Professional | None | $33.11 | $89.13 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $67.61 Typical High $1,819.70 | Professional | None | $39.81 | $67.61 | $1,819.70 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $588.84 | Professional | None | $257.04 | $389.05 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $501.19 Typical High $724.44 | Facility | None | $43.65 | $501.19 | $724.44 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $269.15 Typical High $630.96 | Professional | None | $41.69 | $269.15 | $630.96 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $851.14 | Professional | None | $64.57 | $162.18 | $851.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $67.61 | Facility | None | $52.48 | $61.66 | $67.61 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $72.44 | Professional | None | $53.70 | $64.57 | $72.44 |
Network Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $912.01 | Professional | None | $645.65 | $758.58 | $912.01 |
Oscar Health Setting Professional Modifier None Typical Low $12.30 Median $24.55 Typical High $54.95 | Professional | None | $12.30 | $24.55 | $54.95 |
Pacific Source Setting Facility Modifier None Typical Low $371.54 Median $436.52 Typical High $602.56 | Facility | None | $371.54 | $436.52 | $602.56 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $2,290.87 | Facility | None | $912.01 | $954.99 | $2,290.87 |
Premera BCBS Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $660.69 | Professional | None | $371.54 | $371.54 | $660.69 |
Priority Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $5,128.61 Typical High $5,128.61 | Facility | None | $724.44 | $5,128.61 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $602.56 | Professional | None | $251.19 | $416.87 | $602.56 |
Quartz Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,023.29 | Professional | None | $489.78 | $630.96 | $1,023.29 |
Quartz Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $724.44 | Professional | None | $363.08 | $436.52 | $724.44 |
Regence BlueShield Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $616.60 | Professional | None | $426.58 | $478.63 | $616.60 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Security Health Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,122.02 | Professional | None | $562.34 | $891.25 | $1,122.02 |
Select Health Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Facility | None | $4,265.80 | $4,265.80 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $660.69 | Professional | None | $323.59 | $602.56 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $19.05 Median $31.62 Typical High $97.72 | Facility | None | $19.05 | $31.62 | $97.72 |
Sentara Setting Professional Modifier None Typical Low $22.91 Median $60.26 Typical High $85.11 | Professional | None | $22.91 | $60.26 | $85.11 |
SummaCare Setting Professional Modifier None Typical Low $151.36 Median $354.81 Typical High $524.81 | Professional | None | $151.36 | $354.81 | $524.81 |
Sutter Health Plus Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
The Alliance Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $831.76 | Professional | None | $398.11 | $467.74 | $831.76 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $724.44 | Professional | None | $501.19 | $602.56 | $724.44 |
United Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $89.13 | Professional | None | $39.81 | $57.54 | $89.13 |
Univera Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $309.03 | Facility | None | $141.25 | $141.25 | $309.03 |
Univera Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $501.19 | Professional | None | $117.49 | $141.25 | $501.19 |
University Health Alliance Setting Professional Modifier None Typical Low $10.00 Median $48.98 Typical High $66.07 | Professional | None | $10.00 | $48.98 | $66.07 |
Well Sense Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $371.54 | Facility | None | $173.78 | $239.88 | $371.54 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | None | $158.49 | $158.49 | $190.55 |
Wellmark Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $691.83 | Professional | None | $501.19 | $549.54 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $138.04 | Professional | None | $7.08 | $7.08 | $138.04 |
33 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier AA · Anesthesiologist Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | AA · Anesthesiologist | $467.74 | $467.74 | $549.54 |
BCBS Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $56.23 | $56.23 | $56.23 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $346.74 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $257.04 | $346.74 | $354.81 |
BCBS Setting Professional Modifier AA · Anesthesiologist Typical Low $245.47 Median $257.04 Typical High $457.09 | Professional | AA · Anesthesiologist | $245.47 | $257.04 | $457.09 |
BCBS Setting Professional Modifier AD · Supervising 5+ Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | AD · Supervising 5+ | $239.88 | $239.88 | $239.88 |
BCBS Setting Professional Modifier QX · CRNA, directed Typical Low $64.57 Median $123.03 Typical High $302.00 | Professional | QX · CRNA, directed | $64.57 | $123.03 | $302.00 |
BCBS Setting Professional Modifier QZ · CRNA, independent Typical Low $194.98 Median $436.52 Typical High $562.34 | Professional | QZ · CRNA, independent | $194.98 | $436.52 | $562.34 |
CareFirst Setting Professional Modifier NA Typical Low $2.95 Median $3.31 Typical High $3.55 | Professional | NA | $2.95 | $3.31 | $3.55 |
Cigna Setting Professional Modifier AA · Anesthesiologist Typical Low $562.34 Median $707.95 Typical High $1,047.13 | Professional | AA · Anesthesiologist | $562.34 | $707.95 | $1,047.13 |
Geisinger Setting Professional Modifier AA · Anesthesiologist Typical Low $186.21 Median $426.58 Typical High $630.96 | Professional | AA · Anesthesiologist | $186.21 | $426.58 | $630.96 |
Geisinger Setting Professional Modifier AD · Supervising 5+ Typical Low $186.21 Median $426.58 Typical High $630.96 | Professional | AD · Supervising 5+ | $186.21 | $426.58 | $630.96 |
Geisinger Setting Professional Modifier QK · Directing 2–4 cases Typical Low $186.21 Median $426.58 Typical High $630.96 | Professional | QK · Directing 2–4 cases | $186.21 | $426.58 | $630.96 |
Geisinger Setting Professional Modifier QX · CRNA, directed Typical Low $186.21 Median $426.58 Typical High $630.96 | Professional | QX · CRNA, directed | $186.21 | $426.58 | $630.96 |
Geisinger Setting Professional Modifier QY · Directing one CRNA Typical Low $186.21 Median $426.58 Typical High $630.96 | Professional | QY · Directing one CRNA | $186.21 | $426.58 | $630.96 |
Geisinger Setting Professional Modifier QZ · CRNA, independent Typical Low $186.21 Median $426.58 Typical High $630.96 | Professional | QZ · CRNA, independent | $186.21 | $426.58 | $630.96 |
HMSA Setting Professional Modifier AD · Supervising 5+ Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | AD · Supervising 5+ | $2.45 | $2.45 | $2.45 |
Health Partners Setting Professional Modifier AA · Anesthesiologist Typical Low $426.58 Median $645.65 Typical High $1,698.24 | Professional | AA · Anesthesiologist | $426.58 | $645.65 | $1,698.24 |
Highmark BCBS Setting Professional Modifier QK · Directing 2–4 cases + QX · CRNA, directed Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | QK · Directing 2–4 cases + QX · CRNA, directed | $1,479.11 | $1,479.11 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier P3 · Severe systemic disease Typical Low $239.88 Median $588.84 Typical High $977.24 | Professional | P3 · Severe systemic disease | $239.88 | $588.84 | $977.24 |
Kaiser Permanente Setting Professional Modifier P4 · Life-threatening disease Typical Low $245.47 Median $645.65 Typical High $1,047.13 | Professional | P4 · Life-threatening disease | $245.47 | $645.65 | $1,047.13 |
Kaiser Permanente Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $269.15 Median $707.95 Typical High $1,047.13 | Professional | P5 · Not expected to survive without surgery | $269.15 | $707.95 | $1,047.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P3 · Severe systemic disease Typical Low $288.40 Median $457.09 Typical High $602.56 | Professional | P3 · Severe systemic disease | $288.40 | $457.09 | $602.56 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P4 · Life-threatening disease Typical Low $323.59 Median $512.86 Typical High $676.08 | Professional | P4 · Life-threatening disease | $323.59 | $512.86 | $676.08 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $363.08 Median $575.44 Typical High $741.31 | Professional | P5 · Not expected to survive without surgery | $363.08 | $575.44 | $741.31 |
Security Health Setting Professional Modifier AD · Supervising 5+ Typical Low $208.93 Median $338.84 Typical High $416.87 | Professional | AD · Supervising 5+ | $208.93 | $338.84 | $416.87 |
Security Health Setting Professional Modifier P1 · Healthy patient Typical Low $562.34 Median $562.34 Typical High $1,174.90 | Professional | P1 · Healthy patient | $562.34 | $562.34 | $1,174.90 |
Security Health Setting Professional Modifier P2 · Mild systemic disease Typical Low $562.34 Median $562.34 Typical High $1,174.90 | Professional | P2 · Mild systemic disease | $562.34 | $562.34 | $1,174.90 |
Security Health Setting Professional Modifier P3 · Severe systemic disease Typical Low $630.96 Median $630.96 Typical High $1,318.26 | Professional | P3 · Severe systemic disease | $630.96 | $630.96 | $1,318.26 |
Security Health Setting Professional Modifier P4 · Life-threatening disease Typical Low $691.83 Median $691.83 Typical High $1,479.11 | Professional | P4 · Life-threatening disease | $691.83 | $691.83 | $1,479.11 |
Security Health Setting Professional Modifier P5 · Not expected to survive without surgery Typical Low $758.58 Median $758.58 Typical High $1,621.81 | Professional | P5 · Not expected to survive without surgery | $758.58 | $758.58 | $1,621.81 |
Security Health Setting Professional Modifier P6 · Organ donor Typical Low $562.34 Median $562.34 Typical High $1,174.90 | Professional | P6 · Organ donor | $562.34 | $562.34 | $1,174.90 |
Wellmark Setting Professional Modifier QX · CRNA, directed Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | QX · CRNA, directed | $309.03 | $338.84 | $338.84 |