How much rates vary
Facilitymedian $1,259 · 10th to 90th $363 to $5,012Professionalmedian $214 · 10th to 90th $135 to $479
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 $218.78 Median $2,630.27 Typical High $8,912.51 | Facility | None | $218.78 | $2,630.27 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $316.23 | Professional | None | $173.78 | $199.53 | $316.23 |
AllWays Health Partners Setting Facility Modifier None Typical Low $371.54 Median $1,071.52 Typical High $3,311.31 | Facility | None | $371.54 | $1,071.52 | $3,311.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $204.17 Median $478.63 Typical High $1,445.44 | Professional | None | $204.17 | $478.63 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $338.84 | Professional | None | $169.82 | $186.21 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $3,388.44 Typical High $7,762.47 | Facility | None | $645.65 | $3,388.44 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $398.11 | Professional | None | $169.82 | $218.78 | $398.11 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $165.96 Median $741.31 Typical High $6,165.95 | Facility | None | $165.96 | $741.31 | $6,165.95 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $269.15 Median $1,445.44 Typical High $1,584.89 | Professional | None | $269.15 | $1,445.44 | $1,584.89 |
Aultcare Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
AvMed Setting Facility Modifier None Typical Low $331.13 Median $1,348.96 Typical High $9,549.93 | Facility | None | $331.13 | $1,348.96 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $151.36 Median $199.53 Typical High $218.78 | Professional | None | $151.36 | $199.53 | $218.78 |
BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,445.44 Typical High $3,981.07 | Facility | None | $776.25 | $1,445.44 | $3,981.07 |
BCBS Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $467.74 | Professional | None | $177.83 | $288.40 | $467.74 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,258.93 Typical High $4,677.35 | Facility | None | $100.00 | $1,258.93 | $4,677.35 |
Blue Shield Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $295.12 | Professional | None | $144.54 | $213.80 | $295.12 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Capital Blue Cross Setting Facility Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $56,234.13 | Facility | None | $3,981.07 | $4,365.16 | $56,234.13 |
Capital Blue Cross Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $416.87 | Professional | None | $199.53 | $204.17 | $416.87 |
CareFirst Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $239.88 | Professional | None | $199.53 | $218.78 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $177.83 Median $288.40 Typical High $1,737.80 | Facility | None | $177.83 | $288.40 | $1,737.80 |
CareSource Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $288.40 | Professional | None | $199.53 | $239.88 | $288.40 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $245.47 | Professional | None | $144.54 | $208.93 | $245.47 |
Christus Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,047.13 Typical High $1,819.70 | Facility | None | $389.05 | $1,047.13 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $436.52 | Professional | None | $177.83 | $234.42 | $436.52 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $6,165.95 Typical High $6,309.57 | Facility | None | $446.68 | $6,165.95 | $6,309.57 |
ConnectiCare Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $338.84 | Professional | None | $190.55 | $295.12 | $338.84 |
Contra Costa Health Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $275.42 | Professional | None | $95.50 | $218.78 | $275.42 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $2,754.23 Typical High $5,128.61 | Facility | None | $229.09 | $2,754.23 | $5,128.61 |
DeanCare Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $602.56 | Professional | None | $346.74 | $426.58 | $602.56 |
Denver HMP Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $426.58 | Facility | None | $199.53 | $263.03 | $426.58 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $229.09 Typical High $724.44 | Facility | None | $151.36 | $229.09 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $331.13 | Professional | None | $186.21 | $229.09 | $331.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $257.04 | Professional | None | $112.20 | $173.78 | $257.04 |
Fallon Health Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $3,311.31 | Facility | None | $208.93 | $275.42 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $309.03 | Professional | None | $234.42 | $269.15 | $309.03 |
Florida Blue Setting Facility Modifier None Typical Low $616.60 Median $1,348.96 Typical High $6,309.57 | Facility | None | $616.60 | $1,348.96 | $6,309.57 |
Florida Blue Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $229.09 | Professional | None | $79.43 | $173.78 | $229.09 |
Geisinger Setting Facility Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,862.09 | Facility | None | $851.14 | $1,047.13 | $1,862.09 |
Geisinger Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $407.38 | Professional | None | $181.97 | $239.88 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $1,096.48 | Professional | None | $199.53 | $316.23 | $1,096.48 |
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 $234.42 Median $251.19 Typical High $275.42 | Professional | None | $234.42 | $251.19 | $275.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $4,677.35 | Facility | None | $602.56 | $1,318.26 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $588.84 | Professional | None | $223.87 | $363.08 | $588.84 |
Health Alliance Plan Setting Facility Modifier None Typical Low $263.03 Median $933.25 Typical High $6,025.60 | Facility | None | $263.03 | $933.25 | $6,025.60 |
Health Alliance Plan Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $281.84 | Professional | None | $199.53 | $257.04 | $281.84 |
Health New England Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,466.84 | Facility | None | $1,621.81 | $1,621.81 | $4,466.84 |
Health New England Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Health Partners Setting Facility Modifier None Typical Low $288.40 Median $467.74 Typical High $812.83 | Facility | None | $288.40 | $467.74 | $812.83 |
Health Partners Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $776.25 | Professional | None | $275.42 | $489.78 | $776.25 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $1,778.28 Typical High $5,011.87 | Facility | None | $1,122.02 | $1,778.28 | $5,011.87 |
Highmark BCBS Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $331.13 | Professional | None | $186.21 | $239.88 | $331.13 |
Hometown Health Setting Professional Modifier None Typical Low $3.09 Median $177.83 Typical High $316.23 | Professional | None | $3.09 | $177.83 | $316.23 |
Hometown Health Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Hometown Health Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $275.42 | Professional | None | $2.34 | $2.34 | $275.42 |
Horizon BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $6,456.54 | Facility | None | $1,318.26 | $2,511.89 | $6,456.54 |
Horizon BCBS Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $338.84 | Professional | None | $204.17 | $223.87 | $338.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $467.74 | Professional | None | $190.55 | $239.88 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $218.78 Median $549.54 Typical High $1,659.59 | Professional | None | $218.78 | $549.54 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,445.44 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $204.17 Median $3,235.94 Typical High $4,365.16 | Facility | None | $204.17 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $501.19 | Professional | None | $204.17 | $281.84 | $501.19 |
Martin's Point Setting Facility Modifier None Typical Low $245.47 Median $2,344.23 Typical High $6,606.93 | Facility | None | $245.47 | $2,344.23 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $245.47 | Professional | None | $177.83 | $194.98 | $245.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $371.54 Median $1,071.52 Typical High $3,311.31 | Facility | None | $371.54 | $1,071.52 | $3,311.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $204.17 Median $478.63 Typical High $1,445.44 | Professional | None | $204.17 | $478.63 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $457.09 | Professional | None | $263.03 | $323.59 | $457.09 |
Medcost Setting Facility Modifier None Typical Low $229.09 Median $537.03 Typical High $1,288.25 | Facility | None | $229.09 | $537.03 | $1,288.25 |
Medcost Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $398.11 | Professional | None | $223.87 | $239.88 | $398.11 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $1,230.27 Typical High $4,786.30 | Facility | None | $281.84 | $1,230.27 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $1,445.44 | Professional | None | $177.83 | $363.08 | $1,445.44 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $389.05 Median $933.25 Typical High $1,659.59 | Facility | None | $389.05 | $933.25 | $1,659.59 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $389.05 | Professional | None | $194.98 | $245.47 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $501.19 | Professional | None | $380.19 | $446.68 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,258.93 Typical High $1,698.24 | Facility | None | $645.65 | $1,258.93 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $602.56 | Professional | None | $371.54 | $446.68 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $2,398.83 Typical High $5,128.61 | Facility | None | $275.42 | $2,398.83 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $416.87 | Professional | None | $165.96 | $208.93 | $416.87 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $147.91 Typical High $263.03 | Professional | None | $26.92 | $147.91 | $263.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $275.42 Median $316.23 Typical High $354.81 | Facility | None | $275.42 | $316.23 | $354.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $446.68 | Professional | None | $316.23 | $354.81 | $446.68 |
Network Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,818.38 | $4,786.30 |
Network Health Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $588.84 | Professional | None | $245.47 | $457.09 | $588.84 |
Optum Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $70.79 | Professional | None | $54.95 | $54.95 | $70.79 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $436.52 | Professional | None | $194.98 | $331.13 | $436.52 |
Pacific Source Setting Facility Modifier None Typical Low $229.09 Median $371.54 Typical High $398.11 | Facility | None | $229.09 | $371.54 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $537.03 Median $1,905.46 Typical High $2,398.83 | Facility | None | $537.03 | $1,905.46 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $398.11 | Professional | None | $204.17 | $281.84 | $398.11 |
Premera BCBS Setting Facility Modifier None Typical Low $575.44 Median $954.99 Typical High $1,862.09 | Facility | None | $575.44 | $954.99 | $1,862.09 |
Premera BCBS Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $812.83 | Professional | None | $275.42 | $275.42 | $812.83 |
Prevea360 Setting Facility Modifier None Typical Low $190.55 Median $275.42 Typical High $691.83 | Facility | None | $190.55 | $275.42 | $691.83 |
Priority Health Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Priority Health Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $346.74 | Professional | None | $151.36 | $229.09 | $346.74 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $1,258.93 Typical High $3,311.31 | Facility | None | $346.74 | $1,258.93 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $380.19 | Professional | None | $177.83 | $223.87 | $380.19 |
Qualchoice Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $354.81 | Professional | None | $154.88 | $154.88 | $354.81 |
Quartz Setting Professional Modifier None Typical Low $204.17 Median $467.74 Typical High $831.76 | Professional | None | $204.17 | $467.74 | $831.76 |
Quartz Setting Facility Modifier None Typical Low $630.96 Median $1,584.89 Typical High $2,398.83 | Facility | None | $630.96 | $1,584.89 | $2,398.83 |
Quartz Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | None | $346.74 | $346.74 | $446.68 |
Regence BlueShield Setting Facility Modifier None Typical Low $2,884.03 Median $4,466.84 Typical High $6,165.95 | Facility | None | $2,884.03 | $4,466.84 | $6,165.95 |
Regence BlueShield Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $457.09 | Professional | None | $263.03 | $380.19 | $457.09 |
Sanford Health Plan Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $389.05 | Professional | None | $239.88 | $288.40 | $389.05 |
Security Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
Security Health Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,348.96 | Professional | None | $602.56 | $977.24 | $1,348.96 |
Select Health Setting Facility Modifier None Typical Low $169.82 Median $346.74 Typical High $2,630.27 | Facility | None | $169.82 | $346.74 | $2,630.27 |
Select Health Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $389.05 | Professional | None | $144.54 | $208.93 | $389.05 |
Sentara Setting Facility Modifier None Typical Low $181.97 Median $933.25 Typical High $3,630.78 | Facility | None | $181.97 | $933.25 | $3,630.78 |
Sentara Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $478.63 | Professional | None | $194.98 | $234.42 | $478.63 |
SummaCare Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Facility | None | $446.68 | $467.74 | $537.03 |
SummaCare Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $281.84 | Professional | None | $177.83 | $186.21 | $281.84 |
Sutter Health Plus Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Sutter Health Plus Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
The Alliance Setting Professional Modifier None Typical Low $426.58 Median $870.96 Typical High $1,288.25 | Professional | None | $426.58 | $870.96 | $1,288.25 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $660.69 | Professional | None | $169.82 | $302.00 | $660.69 |
UPMC Health Plan Setting Facility Modifier None Typical Low $190.55 Median $1,122.02 Typical High $2,238.72 | Facility | None | $190.55 | $1,122.02 | $2,238.72 |
UPMC Health Plan Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | None | $190.55 | $223.87 | $223.87 |
United Setting Facility Modifier None Typical Low $354.81 Median $1,000.00 Typical High $4,073.80 | Facility | None | $354.81 | $1,000.00 | $4,073.80 |
United Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $407.38 | Professional | None | $151.36 | $208.93 | $407.38 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $181.97 Typical High $776.25 | Facility | None | $131.83 | $181.97 | $776.25 |
Univera Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | None | $131.83 | $173.78 | $257.04 |
University Health Alliance Setting Professional Modifier None Typical Low $29.51 Median $33.88 Typical High $3,090.30 | Professional | None | $29.51 | $33.88 | $3,090.30 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $602.56 | Facility | None | $162.18 | $295.12 | $602.56 |
Well Sense Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $186.21 | Professional | None | $138.04 | $138.04 | $186.21 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | None | $389.05 | $389.05 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $199.53 | Professional | None | $144.54 | $186.21 | $199.53 |
61 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 52 · Reduced service Typical Low $91.20 Median $97.72 Typical High $134.90 | Facility | 52 · Reduced service | $91.20 | $97.72 | $134.90 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $53.70 | Facility | 53 · Discontinued | $36.31 | $39.81 | $53.70 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $134.90 Median $147.91 Typical High $204.17 | Facility | 54 · Surgery only | $134.90 | $147.91 | $204.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.92 Median $29.51 Typical High $40.74 | Facility | 55 · Aftercare only | $26.92 | $29.51 | $40.74 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $26.92 | Facility | 56 · Pre-op care only | $18.20 | $19.50 | $26.92 |
Aetna Setting Facility Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $138.04 Typical High $190.55 | Facility | 78 · Unplanned return to OR | $125.89 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $34.67 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $208.93 | Professional | 54 · Surgery only | $131.83 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $141.25 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $123.03 | $141.25 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $251.19 Median $316.23 Typical High $575.44 | Professional | 50 · Both sides | $251.19 | $316.23 | $575.44 |
BCBS Setting Facility Modifier 50 · Both sides Typical Low $1,778.28 Median $2,187.76 Typical High $6,165.95 | Facility | 50 · Both sides | $1,778.28 | $2,187.76 | $6,165.95 |
BCBS Setting Professional Modifier 22 · Increased work Typical Low $389.05 Median $501.19 Typical High $588.84 | Professional | 22 · Increased work | $389.05 | $501.19 | $588.84 |
BCBS Setting Professional Modifier 32 · Mandated service Typical Low $257.04 Median $323.59 Typical High $389.05 | Professional | 32 · Mandated service | $257.04 | $323.59 | $389.05 |
BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $575.44 Typical High $912.01 | Professional | 50 · Both sides | $457.09 | $575.44 | $912.01 |
BCBS Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $316.23 Typical High $467.74 | Professional | 54 · Surgery only | $190.55 | $316.23 | $467.74 |
BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $63.10 Typical High $120.23 | Professional | 55 · Aftercare only | $23.99 | $63.10 | $120.23 |
BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.60 | $20.42 | $23.99 |
BCBS Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | 63 · Small infant | $398.11 | $436.52 | $478.63 |
BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $295.12 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $229.09 | $295.12 | $501.19 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $295.12 Median $309.03 Typical High $616.60 | Professional | 50 · Both sides | $295.12 | $309.03 | $616.60 |
Capital Blue Cross Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $165.96 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $158.49 | $165.96 | $331.13 |
DeanCare Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $630.96 Typical High $912.01 | Professional | 50 · Both sides | $512.86 | $630.96 | $912.01 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $208.93 Typical High $302.00 | Professional | 51 · Multiple procedures | $169.82 | $208.93 | $302.00 |
DeanCare Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $338.84 Typical High $489.78 | Professional | 54 · Surgery only | $275.42 | $338.84 | $489.78 |
DeanCare Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $123.03 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $123.03 |
DeanCare Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $288.40 | $354.81 | $512.86 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $100.00 | $158.49 | $234.42 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.38 Typical High $25.70 | Professional | 55 · Aftercare only | $11.22 | $17.38 | $25.70 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.22 | $17.38 | $25.70 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $141.25 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $89.13 | $141.25 | $208.93 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $125.89 | $128.82 | $128.82 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $50.12 | $52.48 | $52.48 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 54 · Surgery only | $186.21 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $38.90 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $26.30 |
Health Alliance Plan Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $173.78 | $181.97 | $181.97 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $107.15 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $107.15 | $154.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $95.50 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $40.74 | Professional | 53 · Discontinued | $35.48 | $38.02 | $40.74 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 54 · Surgery only | $131.83 | $144.54 | $154.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $19.05 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.78 | $19.05 | $20.42 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $134.90 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $123.03 | $134.90 | $144.54 |
Medcost Setting Facility Modifier 50 · Both sides Typical Low $575.44 Median $954.99 Typical High $1,949.84 | Facility | 50 · Both sides | $575.44 | $954.99 | $1,949.84 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $194.98 Median $316.23 Typical High $645.65 | Facility | 51 · Multiple procedures | $194.98 | $316.23 | $645.65 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $416.87 Typical High $616.60 | Professional | 50 · Both sides | $346.74 | $416.87 | $616.60 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $114.82 Median $141.25 Typical High $204.17 | Professional | 51 · Multiple procedures | $114.82 | $141.25 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $100.00 Typical High $199.53 | Professional | 52 · Reduced service | $83.18 | $100.00 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $39.81 Typical High $79.43 | Professional | 53 · Discontinued | $33.11 | $39.81 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $147.91 Typical High $302.00 | Professional | 54 · Surgery only | $123.03 | $147.91 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $60.26 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $39.81 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $39.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $138.04 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $114.82 | $138.04 | $281.84 |
Regence BlueShield Setting Facility Modifier 50 · Both sides Typical Low $4,365.16 Median $6,760.83 Typical High $9,332.54 | Facility | 50 · Both sides | $4,365.16 | $6,760.83 | $9,332.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $100.00 | $158.49 | $234.42 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $17.38 Typical High $51.29 | Professional | 55 · Aftercare only | $11.22 | $17.38 | $51.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.38 Typical High $51.29 | Professional | 56 · Pre-op care only | $11.22 | $17.38 | $51.29 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $141.25 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $89.13 | $141.25 | $208.93 |
What it costs in each state
The same service costs 7.3 times more in Colorado than in Montana. 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.
Physician feeFacility fee
Touch or drag across the chart to see any state's rate.
CO $4,641MT $632
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.