How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,445 to $9,772Professionalmedian $1,698 · 10th to 90th $21 to $10,471
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 $1,584.89 Median $2,290.87 Typical High $9,549.93 | Facility | None | $1,584.89 | $2,290.87 | $9,549.93 |
Aetna Setting Professional Modifier None (both parts) Typical Low $1,148.15 Median $1,659.59 Typical High $2,041.74 | Professional | None (both parts) | $1,148.15 | $1,659.59 | $2,041.74 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $891.25 Median $7,413.10 Typical High $10,471.29 | Professional | None (both parts) | $891.25 | $7,413.10 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $5,248.07 Typical High $10,000.00 | Facility | None | $1,584.89 | $5,248.07 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $20.42 Median $26.92 Typical High $4,265.80 | Professional | None (both parts) | $20.42 | $26.92 | $4,265.80 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $5,888.44 | Facility | None | $1,584.89 | $2,754.23 | $5,888.44 |
Asuris Northwest Health Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $10,471.29 Typical High $15,848.93 | Professional | None (both parts) | $1,819.70 | $10,471.29 | $15,848.93 |
AvMed Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $1,698.24 | $2,137.96 | $2,137.96 |
BCBS Alabama Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
BCBS Arizona Setting Facility Modifier None Typical Low $1,445.44 Median $6,165.95 Typical High $9,332.54 | Facility | None | $1,445.44 | $6,165.95 | $9,332.54 |
BCBS Arizona Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,089.30 Typical High $3,630.78 | Professional | None (both parts) | $2,041.74 | $2,089.30 | $3,630.78 |
BCBS Arkansas Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $1,905.46 Typical High $2,884.03 | Professional | None (both parts) | $1,905.46 | $1,905.46 | $2,884.03 |
BCBS Idaho Setting Facility Modifier None Typical Low $2,137.96 Median $3,630.78 Typical High $7,585.78 | Facility | None | $2,137.96 | $3,630.78 | $7,585.78 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,137.96 Typical High $2,187.76 | Professional | None (both parts) | $1,819.70 | $2,137.96 | $2,187.76 |
BCBS Illinois Setting Facility Modifier None Typical Low $54.95 Median $2,884.03 Typical High $3,467.37 | Facility | None | $54.95 | $2,884.03 | $3,467.37 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $2,630.27 |
BCBS Louisiana Setting Facility Modifier None Typical Low $2,344.23 Median $4,265.80 Typical High $6,606.93 | Facility | None | $2,344.23 | $4,265.80 | $6,606.93 |
BCBS Louisiana Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None (both parts) | $93.33 | $93.33 | $93.33 |
BCBS Michigan Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $1,412.54 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $1,412.54 | $1,479.11 | $1,479.11 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,137.96 | Facility | None | $1,905.46 | $2,137.96 | $2,137.96 |
BCBS Minnesota Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $1,905.46 Typical High $2,137.96 | Professional | None (both parts) | $1,698.24 | $1,905.46 | $2,137.96 |
BCBS Mississippi Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
BCBS Mississippi Setting Professional Modifier None (both parts) Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None (both parts) | $40.74 | $40.74 | $40.74 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $3,235.94 | Facility | None | $1,202.26 | $1,584.89 | $3,235.94 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,344.23 Typical High $6,760.83 | Professional | None (both parts) | $1,819.70 | $2,344.23 | $6,760.83 |
BCBS North Dakota Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,630.78 Typical High $4,265.80 | Professional | None (both parts) | $2,454.71 | $3,630.78 | $4,265.80 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $0.02 Median $4,570.88 Typical High $5,128.61 | Facility | None | $0.02 | $4,570.88 | $5,128.61 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $2,290.87 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $2,290.87 |
BCBS Tennessee Setting Professional Modifier None (both parts) Typical Low $1,096.48 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $1,096.48 | $2,137.96 | $2,137.96 |
Blue Shield Setting Facility Modifier None Typical Low $2,818.38 Median $12,302.69 Typical High $22,908.68 | Facility | None | $2,818.38 | $12,302.69 | $22,908.68 |
Blue Shield Setting Professional Modifier None (both parts) Typical Low $977.24 Median $1,380.38 Typical High $3,630.78 | Professional | None (both parts) | $977.24 | $1,380.38 | $3,630.78 |
Capital Blue Cross Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,659.59 Typical High $1,659.59 | Professional | None (both parts) | $1,318.26 | $1,659.59 | $1,659.59 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | None (both parts) | $1,513.56 | $1,698.24 | $1,698.24 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $28,840.32 Typical High $47,863.01 | Facility | None | $2,041.74 | $28,840.32 | $47,863.01 |
CareSource Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $2,951.21 Typical High $39,810.72 | Professional | None (both parts) | $2,454.71 | $2,951.21 | $39,810.72 |
Central California Alliance for Health Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $1,905.46 Typical High $3,630.78 | Professional | None (both parts) | $1,698.24 | $1,905.46 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $4,168.69 Typical High $7,943.28 | Facility | None | $1,621.81 | $4,168.69 | $7,943.28 |
Cigna Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $3,090.30 Typical High $10,232.93 | Professional | None (both parts) | $2,454.71 | $3,090.30 | $10,232.93 |
ConnectiCare Setting Professional Modifier None (both parts) Typical Low $2,238.72 Median $3,890.45 Typical High $3,890.45 | Professional | None (both parts) | $2,238.72 | $3,890.45 | $3,890.45 |
Contra Costa Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,884.03 | Professional | None | $2,137.96 | $2,344.23 | $2,884.03 |
DeanCare Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $13,489.63 | Facility | None | $2,570.40 | $10,000.00 | $13,489.63 |
DeanCare Setting Professional Modifier None (both parts) Typical Low $12,882.50 Median $12,882.50 Typical High $14,125.38 | Professional | None (both parts) | $12,882.50 | $12,882.50 | $14,125.38 |
Denver HMP Setting Facility Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,884.03 | Facility | None | $1,621.81 | $1,905.46 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,344.23 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,344.23 | $4,786.30 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $2,570.40 Typical High $3,890.45 | Professional | None (both parts) | $1,479.11 | $2,570.40 | $3,890.45 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $2,137.96 Typical High $2,398.83 | Professional | None (both parts) | $1,380.38 | $2,137.96 | $2,398.83 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,548.13 Typical High $5,888.44 | Facility | None | $83.18 | $3,548.13 | $5,888.44 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $3,019.95 Median $3,019.95 Typical High $3,548.13 | Professional | None (both parts) | $3,019.95 | $3,019.95 | $3,548.13 |
Florida Blue Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Florida Blue Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,288.25 Typical High $1,819.70 | Professional | None (both parts) | $1,288.25 | $1,288.25 | $1,819.70 |
Geisinger Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $1,584.89 Median $2,454.71 Typical High $4,168.69 | Professional | None (both parts) | $1,584.89 | $2,454.71 | $4,168.69 |
HMSA Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $2,238.72 Typical High $2,630.27 | Professional | None (both parts) | $1,905.46 | $2,238.72 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $3,890.45 | Professional | None | $1,905.46 | $2,951.21 | $3,890.45 |
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 (both parts) Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None (both parts) | $2,754.23 | $2,754.23 | $2,754.23 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $2,137.96 Typical High $4,786.30 | Professional | None (both parts) | $1,288.25 | $2,137.96 | $4,786.30 |
Health Alliance Plan Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $5,888.44 | Facility | None | $2,041.74 | $2,041.74 | $5,888.44 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $2,041.74 Median $2,041.74 Typical High $2,691.53 | Professional | None (both parts) | $2,041.74 | $2,041.74 | $2,691.53 |
Health Partners Setting Facility Modifier None Typical Low $3,981.07 Median $6,606.93 Typical High $15,488.17 | Facility | None | $3,981.07 | $6,606.93 | $15,488.17 |
Health Partners Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $2,454.71 Typical High $3,801.89 | Professional | None (both parts) | $2,454.71 | $2,454.71 | $3,801.89 |
Hometown Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,137.96 | $3,467.37 |
Horizon BCBS Setting Facility Modifier None Typical Low $7,762.47 Median $17,782.79 Typical High $27,542.29 | Facility | None | $7,762.47 | $17,782.79 | $27,542.29 |
Horizon BCBS Setting Professional Modifier None (both parts) Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None (both parts) | $1,479.11 | $1,479.11 | $1,479.11 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $5,011.87 | Professional | None | $2,041.74 | $2,570.40 | $5,011.87 |
Kaiser Permanente Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $2,454.71 Typical High $5,370.32 | Professional | None (both parts) | $1,698.24 | $2,454.71 | $5,370.32 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $10,471.29 Median $15,848.93 Typical High $15,848.93 | Professional | None (both parts) | $10,471.29 | $15,848.93 | $15,848.93 |
MVP Health Care Setting Facility Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $11,220.18 | Facility | None | $2,137.96 | $3,801.89 | $11,220.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,584.89 Typical High $4,365.16 | Professional | None (both parts) | $1,380.38 | $1,584.89 | $4,365.16 |
Martin's Point Setting Facility Modifier None Typical Low $1,819.70 Median $4,073.80 Typical High $7,585.78 | Facility | None | $1,819.70 | $4,073.80 | $7,585.78 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $1,737.80 Median $1,737.80 Typical High $1,819.70 | Professional | None (both parts) | $1,737.80 | $1,737.80 | $1,819.70 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $891.25 Median $7,413.10 Typical High $10,471.29 | Professional | None (both parts) | $891.25 | $7,413.10 | $10,471.29 |
Medcost Setting Facility Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $6,165.95 | Facility | None | $1,659.59 | $2,137.96 | $6,165.95 |
Medcost Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $10,000.00 | Facility | None | $1,584.89 | $2,754.23 | $10,000.00 |
Medica Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,949.84 Typical High $10,471.29 | Professional | None (both parts) | $891.25 | $1,949.84 | $10,471.29 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $11,748.98 | Facility | None | $2,290.87 | $2,511.89 | $11,748.98 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,890.45 | Professional | None | $2,630.27 | $2,630.27 | $3,890.45 |
Midlands Setting Professional Modifier None (both parts) Typical Low $2,818.38 Median $3,890.45 Typical High $3,890.45 | Professional | None (both parts) | $2,818.38 | $3,890.45 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $9,772.37 | Facility | None | $1,621.81 | $2,570.40 | $9,772.37 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $1,288.25 Median $1,621.81 Typical High $2,951.21 | Professional | None (both parts) | $1,288.25 | $1,621.81 | $2,951.21 |
Molina Setting Professional Modifier None (both parts) Typical Low $30.20 Median $100.00 Typical High $1,737.80 | Professional | None (both parts) | $30.20 | $100.00 | $1,737.80 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,137.96 Median $3,162.28 Typical High $4,168.69 | Facility | None | $2,137.96 | $3,162.28 | $4,168.69 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,884.03 Typical High $3,801.89 | Professional | None (both parts) | $2,137.96 | $2,884.03 | $3,801.89 |
Network Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $6,025.60 | Facility | None | $2,290.87 | $2,570.40 | $6,025.60 |
Network Health Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $3,162.28 Typical High $3,630.78 | Professional | None (both parts) | $2,137.96 | $3,162.28 | $3,630.78 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,630.27 Typical High $4,570.88 | Professional | None (both parts) | $2,137.96 | $2,630.27 | $4,570.88 |
Pacific Source Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,344.23 | Facility | None | $2,137.96 | $2,137.96 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $6,760.83 | Facility | None | $3,162.28 | $5,370.32 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $1,819.70 Typical High $1,862.09 | Professional | None (both parts) | $1,819.70 | $1,819.70 | $1,862.09 |
Premera BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $3,715.35 Typical High $7,413.10 | Facility | None | $2,344.23 | $3,715.35 | $7,413.10 |
Premera BCBS Setting Professional Modifier None (both parts) Typical Low $1,905.46 Median $1,905.46 Typical High $4,786.30 | Professional | None (both parts) | $1,905.46 | $1,905.46 | $4,786.30 |
Prevea360 Setting Facility Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $4,265.80 | Facility | None | $1,621.81 | $2,570.40 | $4,265.80 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $2,454.71 Median $2,454.71 Typical High $2,570.40 | Professional | None (both parts) | $2,454.71 | $2,454.71 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $1,621.81 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,621.81 | $3,467.37 | $6,918.31 |
Providence Setting Professional Modifier None (both parts) Typical Low $79.43 Median $2,344.23 Typical High $3,090.30 | Professional | None (both parts) | $79.43 | $2,344.23 | $3,090.30 |
Quartz Setting Professional Modifier None Typical Low $2,344.23 Median $4,897.79 Typical High $6,456.54 | Professional | None | $2,344.23 | $4,897.79 | $6,456.54 |
Quartz Setting Professional Modifier None (both parts) Typical Low $2,630.27 Median $2,630.27 Typical High $5,495.41 | Professional | None (both parts) | $2,630.27 | $2,630.27 | $5,495.41 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,454.71 Median $4,265.80 Typical High $7,585.78 | Facility | None | $2,454.71 | $4,265.80 | $7,585.78 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $1,698.24 Median $1,819.70 Typical High $2,570.40 | Professional | None (both parts) | $1,698.24 | $1,819.70 | $2,570.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,548.13 Median $5,011.87 Typical High $5,888.44 | Professional | None | $3,548.13 | $5,011.87 | $5,888.44 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Security Health Setting Professional Modifier None (both parts) Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None (both parts) | $11,481.54 | $11,481.54 | $11,481.54 |
Select Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,265.80 | Facility | None | $2,137.96 | $2,137.96 | $4,265.80 |
Select Health Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $5,011.87 | Facility | None | $1,513.56 | $2,570.40 | $5,011.87 |
Sentara Setting Professional Modifier None (both parts) Typical Low $1,949.84 Median $2,454.71 Typical High $4,073.80 | Professional | None (both parts) | $1,949.84 | $2,454.71 | $4,073.80 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $1,819.70 Median $2,630.27 Typical High $2,951.21 | Professional | None (both parts) | $1,819.70 | $2,630.27 | $2,951.21 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,344.23 | $3,162.28 |
United Setting Professional Modifier None (both parts) Typical Low $891.25 Median $1,288.25 Typical High $3,162.28 | Professional | None (both parts) | $891.25 | $1,288.25 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $1,380.38 Median $2,187.76 Typical High $2,454.71 | Facility | None | $1,380.38 | $2,187.76 | $2,454.71 |
Univera Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $2,137.96 Typical High $2,344.23 | Professional | None (both parts) | $1,380.38 | $2,137.96 | $2,344.23 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None (both parts) | $2,511.89 | $2,511.89 | $3,019.95 |
Wellmark Setting Professional Modifier None (both parts) Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None (both parts) | $2,137.96 | $2,137.96 | $2,137.96 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $21.38 Median $21.38 Typical High $2,137.96 | Professional | None (both parts) | $21.38 | $21.38 | $2,137.96 |
45 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 |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier 26 · Professional part Typical Low $1,698.24 Median $1,995.26 Typical High $2,570.40 | Facility | 26 · Professional part | $1,698.24 | $1,995.26 | $2,570.40 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $794.33 Median $1,122.02 Typical High $4,786.30 | Facility | 52 · Reduced service | $794.33 | $1,122.02 | $4,786.30 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $316.23 Median $446.68 Typical High $1,905.46 | Facility | 53 · Discontinued | $316.23 | $446.68 | $1,905.46 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $1,584.89 Median $1,737.80 Typical High $2,570.40 | Professional | 26 · Professional part | $1,584.89 | $1,737.80 | $2,570.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $851.14 Typical High $1,230.27 | Professional | 52 · Reduced service | $575.44 | $851.14 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $338.84 Typical High $489.78 | Professional | 53 · Discontinued | $234.42 | $338.84 | $489.78 |
AllWays Health Partners Setting Professional Modifier TC · Technical part Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | TC · Technical part | $10,715.19 | $10,715.19 | $10,715.19 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $2,454.71 Median $3,548.13 Typical High $4,570.88 | Professional | TC · Technical part | $2,454.71 | $3,548.13 | $4,570.88 |
Asuris Northwest Health Setting Professional Modifier TC · Technical part Typical Low $10,715.19 Median $15,848.93 Typical High $15,848.93 | Professional | TC · Technical part | $10,715.19 | $15,848.93 | $15,848.93 |
BCBS Alabama Setting Professional Modifier 12 + 32 · Mandated service + 81 · Minimal assistant surgeon Typical Low $218.78 Median $269.15 Typical High $1,380.38 | Professional | 12 + 32 · Mandated service + 81 · Minimal assistant surgeon | $218.78 | $269.15 | $1,380.38 |
BCBS Arkansas Setting Professional Modifier 26 · Professional part Typical Low $134.90 Median $134.90 Typical High $199.53 | Professional | 26 · Professional part | $134.90 | $134.90 | $199.53 |
BCBS Arkansas Setting Professional Modifier TC · Technical part Typical Low $1,778.28 Median $1,778.28 Typical High $2,691.53 | Professional | TC · Technical part | $1,778.28 | $1,778.28 | $2,691.53 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,513.56 | $1,513.56 |
BCBS Louisiana Setting Professional Modifier 26 · Professional part Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 26 · Professional part | $31.62 | $31.62 | $31.62 |
BCBS Louisiana Setting Professional Modifier TC · Technical part Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | TC · Technical part | $60.26 | $60.26 | $60.26 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $2,951.21 Median $4,365.16 Typical High $5,128.61 | Professional | 22 · Increased work | $2,951.21 | $4,365.16 | $5,128.61 |
Cigna Setting Facility Modifier TC · Technical part Typical Low $489.78 Median $2,290.87 Typical High $3,311.31 | Facility | TC · Technical part | $489.78 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $2,089.30 Median $5,495.41 Typical High $10,232.93 | Professional | TC · Technical part | $2,089.30 | $5,495.41 | $10,232.93 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $2,137.96 Median $2,754.23 Typical High $3,311.31 | Facility | QW · Waived lab test | $2,137.96 | $2,754.23 | $3,311.31 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,584.89 | Facility | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,584.89 |
Health Alliance Plan Setting Facility Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $630.96 | Facility | 53 · Discontinued | $407.38 | $407.38 | $630.96 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | 26 · Professional part | $2,041.74 | $2,041.74 | $2,041.74 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,000.00 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $407.38 | $407.38 | $407.38 |
Kaiser Permanente Setting Professional Modifier TC · Technical part Typical Low $2,290.87 Median $2,951.21 Typical High $5,370.32 | Professional | TC · Technical part | $2,290.87 | $2,951.21 | $5,370.32 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $10,715.19 Median $10,715.19 Typical High $15,848.93 | Professional | TC · Technical part | $10,715.19 | $10,715.19 | $15,848.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $870.96 | $912.01 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | 53 · Discontinued | $346.74 | $346.74 | $363.08 |
Mass General Brigham Setting Professional Modifier TC · Technical part Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | TC · Technical part | $10,715.19 | $10,715.19 | $10,715.19 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $851.14 Median $851.14 Typical High $1,479.11 | Professional | 26 · Professional part | $851.14 | $851.14 | $1,479.11 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $3,162.28 Median $3,162.28 Typical High $5,888.44 | Professional | 50 · Both sides | $3,162.28 | $3,162.28 | $5,888.44 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $1,071.52 Median $1,071.52 Typical High $1,995.26 | Professional | 51 · Multiple procedures | $1,071.52 | $1,071.52 | $1,995.26 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $426.58 Typical High $794.33 | Professional | 80 · Assistant surgeon | $426.58 | $426.58 | $794.33 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $295.12 Median $295.12 Typical High $549.54 | Professional | 81 · Minimal assistant surgeon | $295.12 | $295.12 | $549.54 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $295.12 Median $295.12 Typical High $549.54 | Professional | 82 · Assistant surgeon, no resident | $295.12 | $295.12 | $549.54 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $295.12 Typical High $549.54 | Professional | AS · PA/NP assist | $295.12 | $295.12 | $549.54 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $1,949.84 Median $1,949.84 Typical High $3,388.44 | Professional | TC · Technical part | $1,949.84 | $1,949.84 | $3,388.44 |
Medica Setting Professional Modifier TC · Technical part Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | TC · Technical part | $10,964.78 | $10,964.78 | $10,964.78 |
Midlands Setting Professional Modifier TC · Technical part Typical Low $2,691.53 Median $4,168.69 Typical High $5,754.40 | Professional | TC · Technical part | $2,691.53 | $4,168.69 | $5,754.40 |
Midlands Setting Facility Modifier TC · Technical part Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | TC · Technical part | $2,570.40 | $2,570.40 | $2,570.40 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $812.83 Median $1,905.46 Typical High $5,754.40 | Facility | 52 · Reduced service | $812.83 | $1,905.46 | $5,754.40 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $323.59 Median $758.58 Typical High $2,290.87 | Facility | 53 · Discontinued | $323.59 | $758.58 | $2,290.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $707.95 Typical High $2,089.30 | Professional | 52 · Reduced service | $630.96 | $707.95 | $2,089.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $831.76 | Professional | 53 · Discontinued | $257.04 | $281.84 | $831.76 |
Sentara Setting Professional Modifier TC · Technical part Typical Low $2,137.96 Median $2,454.71 Typical High $3,981.07 | Professional | TC · Technical part | $2,137.96 | $2,454.71 | $3,981.07 |
What it costs in each state
The same service costs 229.1 times more in Texas than in Ohio. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Touch or drag across the chart to see any state's rate.
TX $10,471OH $45.71
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.