How much rates vary
Facilitymedian $1,023 · 10th to 90th $407 to $4,169Professionalmedian $316 · 10th to 90th $166 to $692
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 $239.88 Median $1,949.84 Typical High $5,623.41 | Facility | None | $239.88 | $1,949.84 | $5,623.41 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $63.10 Median $134.90 Typical High $281.84 | Facility | 53 · Discontinued | $63.10 | $134.90 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $537.03 | Professional | None | $181.97 | $323.59 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $89.13 Typical High $213.80 | Professional | 53 · Discontinued | $40.74 | $89.13 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $3,548.13 | Facility | None | $407.38 | $870.96 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $239.88 Median $512.86 Typical High $2,884.03 | Professional | None | $239.88 | $512.86 | $2,884.03 |
AllWays Health Partners Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $234.42 Typical High $562.34 | Professional | 53 · Discontinued | $104.71 | $234.42 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $323.59 | Professional | None | $144.54 | $173.78 | $323.59 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $81.28 Typical High $169.82 | Professional | 53 · Discontinued | $40.74 | $81.28 | $169.82 |
AmeriHealth Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $1,698.24 | Facility | None | $302.00 | $457.09 | $1,698.24 |
AmeriHealth Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $489.78 | Professional | None | $120.23 | $229.09 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $2,570.40 Typical High $5,370.32 | Facility | None | $630.96 | $2,570.40 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $478.63 | Professional | None | $199.53 | $295.12 | $478.63 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $131.83 Typical High $263.03 | Professional | 53 · Discontinued | $79.43 | $131.83 | $263.03 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $147.91 Median $933.25 Typical High $3,467.37 | Facility | None | $147.91 | $933.25 | $3,467.37 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $288.40 Median $676.08 Typical High $3,235.94 | Professional | None | $288.40 | $676.08 | $3,235.94 |
Asuris Northwest Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $251.19 Typical High $338.84 | Professional | 53 · Discontinued | $144.54 | $251.19 | $338.84 |
Aultcare Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $295.12 | Professional | None | $190.55 | $190.55 | $295.12 |
AvMed Setting Facility Modifier None Typical Low $204.17 Median $1,000.00 Typical High $9,549.93 | Facility | None | $204.17 | $1,000.00 | $9,549.93 |
AvMed Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $363.08 | Professional | None | $85.11 | $165.96 | $363.08 |
BCBS Alabama Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
BCBS Alabama Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $831.76 | Professional | None | $208.93 | $208.93 | $831.76 |
BCBS Arizona Setting Facility Modifier None Typical Low $549.54 Median $1,318.26 Typical High $3,467.37 | Facility | None | $549.54 | $1,318.26 | $3,467.37 |
BCBS Arizona Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $457.09 | Professional | None | $204.17 | $371.54 | $457.09 |
BCBS Arkansas Setting Facility Modifier None Typical Low $489.78 Median $851.14 Typical High $1,148.15 | Facility | None | $489.78 | $851.14 | $1,148.15 |
BCBS Arkansas Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $478.63 | Professional | None | $194.98 | $257.04 | $478.63 |
BCBS Idaho Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $2,187.76 | Facility | None | $1,122.02 | $1,258.93 | $2,187.76 |
BCBS Idaho Setting Professional Modifier None Typical Low $309.03 Median $575.44 Typical High $794.33 | Professional | None | $309.03 | $575.44 | $794.33 |
BCBS Idaho Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $288.40 Typical High $398.11 | Professional | 53 · Discontinued | $154.88 | $288.40 | $398.11 |
BCBS Illinois Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $2,630.27 | Facility | None | $776.25 | $1,174.90 | $2,630.27 |
BCBS Illinois Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $676.08 | Professional | None | $194.98 | $371.54 | $676.08 |
BCBS Kansas Setting Facility Modifier None Typical Low $616.60 Median $1,258.93 Typical High $1,318.26 | Facility | None | $616.60 | $1,258.93 | $1,318.26 |
BCBS Kansas Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $602.56 | Professional | None | $407.38 | $407.38 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $501.19 | Professional | None | $169.82 | $371.54 | $501.19 |
BCBS Kansas City Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $186.21 Typical High $251.19 | Professional | 53 · Discontinued | $85.11 | $186.21 | $251.19 |
BCBS Louisiana Setting Facility Modifier None Typical Low $537.03 Median $776.25 Typical High $2,041.74 | Facility | None | $537.03 | $776.25 | $2,041.74 |
BCBS Louisiana Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $537.03 | Professional | None | $245.47 | $371.54 | $537.03 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $245.47 Median $295.12 Typical High $562.34 | Facility | None | $245.47 | $295.12 | $562.34 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $741.31 | Professional | None | $245.47 | $446.68 | $741.31 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $112.20 Typical High $194.98 | Professional | 53 · Discontinued | $61.66 | $112.20 | $194.98 |
BCBS Michigan Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $2,511.89 | Facility | None | $794.33 | $1,023.29 | $2,511.89 |
BCBS Michigan Setting Professional Modifier None Typical Low $43.65 Median $257.04 Typical High $630.96 | Professional | None | $43.65 | $257.04 | $630.96 |
BCBS Minnesota Setting Facility Modifier None Typical Low $1,122.02 Median $3,467.37 Typical High $3,801.89 | Facility | None | $1,122.02 | $3,467.37 | $3,801.89 |
BCBS Minnesota Setting Professional Modifier None Typical Low $281.84 Median $575.44 Typical High $1,000.00 | Professional | None | $281.84 | $575.44 | $1,000.00 |
BCBS Mississippi Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $575.44 | Facility | None | $524.81 | $524.81 | $575.44 |
BCBS Mississippi Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
BCBS Montana 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 |
BCBS Montana Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $537.03 | Professional | None | $288.40 | $288.40 | $537.03 |
BCBS Nebraska Setting Facility Modifier None Typical Low $1,096.48 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,096.48 | $3,311.31 | $6,760.83 |
BCBS Nebraska Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $794.33 | Professional | None | $707.95 | $724.44 | $794.33 |
BCBS New Mexico Setting Facility Modifier None Typical Low $537.03 Median $851.14 Typical High $4,466.84 | Facility | None | $537.03 | $851.14 | $4,466.84 |
BCBS New Mexico Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $426.58 | Professional | None | $208.93 | $346.74 | $426.58 |
BCBS North Carolina Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $1,000.00 | Facility | None | $501.19 | $741.31 | $1,000.00 |
BCBS North Carolina Setting Professional Modifier None Typical Low $323.59 Median $691.83 Typical High $1,000.00 | Professional | None | $323.59 | $691.83 | $1,000.00 |
BCBS North Dakota Setting Facility Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,041.74 | Facility | None | $1,122.02 | $1,348.96 | $2,041.74 |
BCBS North Dakota Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | None | $660.69 | $794.33 | $954.99 |
BCBS North Dakota Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $371.54 Typical High $436.52 | Professional | 53 · Discontinued | $288.40 | $371.54 | $436.52 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $501.19 Median $1,380.38 Typical High $2,238.72 | Facility | None | $501.19 | $1,380.38 | $2,238.72 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $446.68 | Professional | None | $177.83 | $331.13 | $446.68 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $208.93 Median $389.05 Typical High $457.09 | Professional | None | $208.93 | $389.05 | $457.09 |
BCBS South Carolina Setting Facility Modifier None Typical Low $616.60 Median $870.96 Typical High $2,570.40 | Facility | None | $616.60 | $870.96 | $2,570.40 |
BCBS South Carolina Setting Professional Modifier None Typical Low $158.49 Median $407.38 Typical High $776.25 | Professional | None | $158.49 | $407.38 | $776.25 |
BCBS South Carolina Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $79.43 | $177.83 | $177.83 |
BCBS Tennessee Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Tennessee Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $537.03 | Professional | None | $190.55 | $323.59 | $537.03 |
BCBS Tennessee Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $154.88 Typical High $257.04 | Professional | 53 · Discontinued | $91.20 | $154.88 | $257.04 |
BCBS Texas Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $2,187.76 | Facility | None | $478.63 | $891.25 | $2,187.76 |
BCBS Texas Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $426.58 | Professional | None | $158.49 | $275.42 | $426.58 |
BCBS Vermont Setting Facility Modifier None Typical Low $1,258.93 Median $2,511.89 Typical High $3,090.30 | Facility | None | $1,258.93 | $2,511.89 | $3,090.30 |
BCBS Vermont Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $645.65 | Professional | None | $549.54 | $645.65 | $645.65 |
BCBS Wyoming Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
BCBS Wyoming Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $724.44 | Professional | None | $467.74 | $724.44 | $724.44 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $870.96 Typical High $1,380.38 | Professional | 53 · Discontinued | $467.74 | $870.96 | $1,380.38 |
Baylor Scott & White Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $316.23 | Professional | None | $162.18 | $173.78 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $100.00 Median $1,148.15 Typical High $6,165.95 | Facility | None | $100.00 | $1,148.15 | $6,165.95 |
Blue Shield Setting Professional Modifier None Typical Low $165.96 Median $288.40 Typical High $467.74 | Professional | None | $165.96 | $288.40 | $467.74 |
Blue Shield Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $512.86 Typical High $1,071.52 | Professional | 53 · Discontinued | $302.00 | $512.86 | $1,071.52 |
CDPHP Setting Facility Modifier None Typical Low $501.19 Median $1,513.56 Typical High $4,786.30 | Facility | None | $501.19 | $1,513.56 | $4,786.30 |
CDPHP Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $489.78 | Professional | None | $128.82 | $245.47 | $489.78 |
Capital Blue Cross Setting Facility Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $8,709.64 | Facility | None | $2,089.30 | $2,630.27 | $8,709.64 |
Capital Blue Cross Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $724.44 | Professional | None | $346.74 | $537.03 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $251.19 | Professional | None | $177.83 | $194.98 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $831.76 | Facility | None | $134.90 | $229.09 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $38.02 Median $208.93 Typical High $407.38 | Professional | None | $38.02 | $208.93 | $407.38 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $208.93 Median $446.68 Typical High $549.54 | Professional | None | $208.93 | $446.68 | $549.54 |
Christus Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $1,862.09 | Facility | None | $478.63 | $707.95 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $575.44 | Professional | None | $186.21 | $316.23 | $575.44 |
Cigna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $218.78 Typical High $363.08 | Professional | 53 · Discontinued | $107.15 | $218.78 | $363.08 |
Community Health Options Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Community Health Options Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $371.54 | Professional | None | $213.80 | $295.12 | $371.54 |
ConnectiCare Setting Facility Modifier None Typical Low $446.68 Median $616.60 Typical High $1,513.56 | Facility | None | $446.68 | $616.60 | $1,513.56 |
ConnectiCare Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $1,000.00 | Professional | None | $346.74 | $660.69 | $1,000.00 |
ConnectiCare Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $309.03 Typical High $380.19 | Professional | 53 · Discontinued | $223.87 | $309.03 | $380.19 |
Contra Costa Health Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $537.03 | Professional | None | $186.21 | $295.12 | $537.03 |
DeanCare Setting Facility Modifier None Typical Low $281.84 Median $3,090.30 Typical High $5,370.32 | Facility | None | $281.84 | $3,090.30 | $5,370.32 |
DeanCare Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $912.01 | Professional | None | $316.23 | $588.84 | $912.01 |
Denver HMP Setting Facility Modifier None Typical Low $186.21 Median $346.74 Typical High $588.84 | Facility | None | $186.21 | $346.74 | $588.84 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $251.19 Typical High $676.08 | Facility | None | $190.55 | $251.19 | $676.08 |
Emblem Health Setting Facility Modifier 53 · Discontinued Typical Low $89.13 Median $144.54 Typical High $338.84 | Facility | 53 · Discontinued | $89.13 | $144.54 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $81.28 Median $389.05 Typical High $389.05 | Professional | None | $81.28 | $389.05 | $389.05 |
Emblem Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $263.03 Typical High $416.87 | Professional | 53 · Discontinued | $223.87 | $263.03 | $416.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $812.83 | Professional | None | $295.12 | $346.74 | $812.83 |
Excellus BCBS Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $181.97 Typical High $588.84 | Professional | 53 · Discontinued | $107.15 | $181.97 | $588.84 |
Fallon Health Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $3,311.31 | Facility | None | $181.97 | $239.88 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $776.25 | Professional | None | $489.78 | $575.44 | $776.25 |
Florida Blue Setting Facility Modifier None Typical Low $363.08 Median $776.25 Typical High $4,570.88 | Facility | None | $363.08 | $776.25 | $4,570.88 |
Florida Blue Setting Professional Modifier None Typical Low $177.83 Median $371.54 Typical High $436.52 | Professional | None | $177.83 | $371.54 | $436.52 |
Florida Blue Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $104.71 Typical High $213.80 | Professional | 53 · Discontinued | $60.26 | $104.71 | $213.80 |
Geisinger Setting Facility Modifier None Typical Low $501.19 Median $616.60 Typical High $1,096.48 | Facility | None | $501.19 | $616.60 | $1,096.48 |
Geisinger Setting Professional Modifier None Typical Low $218.78 Median $398.11 Typical High $645.65 | Professional | None | $218.78 | $398.11 | $645.65 |
Geisinger Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $162.18 Typical High $295.12 | Professional | 53 · Discontinued | $61.66 | $162.18 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $446.68 Typical High $1,047.13 | Professional | None | $223.87 | $446.68 | $1,047.13 |
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 $213.80 Median $229.09 Typical High $446.68 | Professional | None | $213.80 | $229.09 | $446.68 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $4,786.30 | Facility | None | $602.56 | $1,318.26 | $4,786.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $457.09 Typical High $1,047.13 | Professional | None | $208.93 | $457.09 | $1,047.13 |
Health Alliance Plan Setting Facility Modifier None Typical Low $416.87 Median $1,479.11 Typical High $3,548.13 | Facility | None | $416.87 | $1,479.11 | $3,548.13 |
Health Alliance Plan Setting Facility Modifier 53 · Discontinued Typical Low $117.49 Median $208.93 Typical High $380.19 | Facility | 53 · Discontinued | $117.49 | $208.93 | $380.19 |
Health Alliance Plan Setting Professional Modifier None Typical Low $234.42 Median $426.58 Typical High $537.03 | Professional | None | $234.42 | $426.58 | $537.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $141.25 Typical High $213.80 | Professional | 53 · Discontinued | $46.77 | $141.25 | $213.80 |
Health New England Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $2,511.89 | Facility | None | $812.83 | $1,778.28 | $2,511.89 |
Health New England Setting Professional Modifier None Typical Low $190.55 Median $389.05 Typical High $645.65 | Professional | None | $190.55 | $389.05 | $645.65 |
Health Partners Setting Facility Modifier None Typical Low $501.19 Median $812.83 Typical High $1,412.54 | Facility | None | $501.19 | $812.83 | $1,412.54 |
Health Partners Setting Professional Modifier None Typical Low $295.12 Median $562.34 Typical High $1,122.02 | Professional | None | $295.12 | $562.34 | $1,122.02 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Health Smart Setting Professional Modifier None Typical Low $234.42 Median $257.04 Typical High $1,621.81 | Professional | None | $234.42 | $257.04 | $1,621.81 |
Highmark BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,819.70 Typical High $3,801.89 | Facility | None | $794.33 | $1,819.70 | $3,801.89 |
Highmark BCBS Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $380.19 | Professional | None | $194.98 | $234.42 | $380.19 |
Highmark BCBS Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $218.78 Typical High $331.13 | Professional | 53 · Discontinued | $141.25 | $218.78 | $331.13 |
Hometown Health Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $562.34 | Professional | None | $173.78 | $323.59 | $562.34 |
Hometown Health Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Hometown Health Setting Professional Modifier None Typical Low $3.09 Median $245.47 Typical High $794.33 | Professional | None | $3.09 | $245.47 | $794.33 |
Horizon BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,445.44 Typical High $3,467.37 | Facility | None | $794.33 | $1,445.44 | $3,467.37 |
Horizon BCBS Setting Professional Modifier None Typical Low $173.78 Median $380.19 Typical High $549.54 | Professional | None | $173.78 | $380.19 | $549.54 |
Independence Blue Cross Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $398.11 | Facility | None | $309.03 | $309.03 | $398.11 |
Independence Blue Cross Setting Professional Modifier None Typical Low $114.82 Median $229.09 Typical High $263.03 | Professional | None | $114.82 | $229.09 | $263.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $169.82 Median $398.11 Typical High $707.95 | Professional | None | $169.82 | $398.11 | $707.95 |
Kaiser Permanente Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $234.42 Typical High $501.19 | Professional | 53 · Discontinued | $93.33 | $234.42 | $501.19 |
Kaiser Permanente Setting Professional Modifier None Typical Low $123.03 Median $316.23 Typical High $812.83 | Professional | None | $123.03 | $316.23 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,884.03 | $2,884.03 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $223.87 Median $1,819.70 Typical High $8,511.38 | Facility | None | $223.87 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $512.86 | Professional | None | $346.74 | $346.74 | $512.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $407.38 | $478.63 | $478.63 |
Martin's Point Setting Facility Modifier None Typical Low $223.87 Median $1,778.28 Typical High $5,011.87 | Facility | None | $223.87 | $1,778.28 | $5,011.87 |
Martin's Point Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $162.18 Typical High $281.84 | Facility | 53 · Discontinued | $85.11 | $162.18 | $281.84 |
Martin's Point Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $436.52 | Professional | None | $173.78 | $323.59 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $70.79 Typical High $177.83 | Professional | 53 · Discontinued | $36.31 | $70.79 | $177.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $407.38 Median $870.96 Typical High $3,548.13 | Facility | None | $407.38 | $870.96 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $239.88 Median $512.86 Typical High $2,884.03 | Professional | None | $239.88 | $512.86 | $2,884.03 |
Mass General Brigham Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $234.42 Typical High $562.34 | Professional | 53 · Discontinued | $104.71 | $234.42 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $602.56 | Professional | None | $478.63 | $602.56 | $602.56 |
Medcost Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $120.23 | $194.98 | $194.98 |
Medcost Setting Facility Modifier None Typical Low $288.40 Median $549.54 Typical High $977.24 | Facility | None | $288.40 | $549.54 | $977.24 |
Medcost Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $602.56 | Professional | None | $389.05 | $501.19 | $602.56 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,258.93 Typical High $3,467.37 | Facility | None | $380.19 | $1,258.93 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,348.96 Typical High $2,754.23 | Professional | None | $338.84 | $1,348.96 | $2,754.23 |
Medica Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $346.74 Typical High $1,348.96 | Professional | 53 · Discontinued | $169.82 | $346.74 | $1,348.96 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $2,754.23 | Facility | None | $501.19 | $1,023.29 | $2,754.23 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $501.19 | Professional | None | $141.25 | $281.84 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $933.25 | Professional | None | $407.38 | $741.31 | $933.25 |
Midlands Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $346.74 Typical High $467.74 | Professional | 53 · Discontinued | $181.97 | $346.74 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,000.00 | Facility | None | $616.60 | $831.76 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $758.58 Typical High $977.24 | Professional | None | $363.08 | $758.58 | $977.24 |
Midlands Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $338.84 Typical High $489.78 | Professional | 53 · Discontinued | $181.97 | $338.84 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $1,995.26 Typical High $5,370.32 | Facility | None | $407.38 | $1,995.26 | $5,370.32 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $93.33 Median $194.98 Typical High $602.56 | Facility | 53 · Discontinued | $93.33 | $194.98 | $602.56 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $346.74 Typical High $660.69 | Professional | None | $177.83 | $346.74 | $660.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $93.33 Typical High $213.80 | Professional | 53 · Discontinued | $37.15 | $93.33 | $213.80 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $208.93 Typical High $457.09 | Professional | None | $34.67 | $208.93 | $457.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $281.84 Median $389.05 Typical High $741.31 | Facility | None | $281.84 | $389.05 | $741.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $645.65 Typical High $812.83 | Professional | None | $281.84 | $645.65 | $812.83 |
MountainHealth Co-op Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $114.82 Typical High $208.93 | Professional | 53 · Discontinued | $91.20 | $114.82 | $208.93 |
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 $489.78 Median $707.95 Typical High $912.01 | Professional | None | $489.78 | $707.95 | $912.01 |
Network Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $323.59 Typical High $426.58 | Professional | 53 · Discontinued | $144.54 | $323.59 | $426.58 |
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 Facility Modifier None Typical Low $489.78 Median $1,318.26 Typical High $4,265.80 | Facility | None | $489.78 | $1,318.26 | $4,265.80 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $331.13 Typical High $741.31 | Professional | None | $147.91 | $331.13 | $741.31 |
Pacific Source Setting Facility Modifier None Typical Low $309.03 Median $562.34 Typical High $691.83 | Facility | None | $309.03 | $562.34 | $691.83 |
Pacific Source Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $575.44 | Professional | None | $309.03 | $323.59 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $2,290.87 | Facility | None | $707.95 | $1,288.25 | $2,290.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $575.44 | Professional | None | $199.53 | $363.08 | $575.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $181.97 Typical High $288.40 | Professional | 53 · Discontinued | $100.00 | $181.97 | $288.40 |
Premera BCBS Setting Facility Modifier None Typical Low $380.19 Median $549.54 Typical High $1,071.52 | Facility | None | $380.19 | $549.54 | $1,071.52 |
Premera BCBS Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $1,380.38 | Professional | None | $251.19 | $467.74 | $1,380.38 |
Prevea360 Setting Facility Modifier None Typical Low $199.53 Median $371.54 Typical High $575.44 | Facility | None | $199.53 | $371.54 | $575.44 |
Priority Health Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Priority Health Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $549.54 | Professional | None | $190.55 | $323.59 | $549.54 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $831.76 Typical High $3,801.89 | Facility | None | $436.52 | $831.76 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $537.03 | Professional | None | $194.98 | $338.84 | $537.03 |
Providence Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $269.15 | Professional | 53 · Discontinued | $128.82 | $165.96 | $269.15 |
Qualchoice Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $630.96 | Professional | None | $331.13 | $630.96 | $630.96 |
Qualchoice Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $141.25 | $154.88 |
Quartz Setting Professional Modifier None Typical Low $275.42 Median $676.08 Typical High $1,380.38 | Professional | None | $275.42 | $676.08 | $1,380.38 |
Quartz Setting Facility Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,548.82 | Facility | None | $707.95 | $1,000.00 | $1,548.82 |
Quartz Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Professional | None | $338.84 | $524.81 | $707.95 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $3,715.35 | Facility | None | $1,584.89 | $2,454.71 | $3,715.35 |
Regence BlueShield Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $676.08 | Professional | None | $269.15 | $446.68 | $676.08 |
Regence BlueShield Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $223.87 Typical High $338.84 | Professional | 53 · Discontinued | $134.90 | $223.87 | $338.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $645.65 | Professional | None | $263.03 | $467.74 | $645.65 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,288.25 | Professional | None | $660.69 | $660.69 | $1,288.25 |
Security Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $323.59 | Professional | 53 · Discontinued | $165.96 | $165.96 | $323.59 |
Security Health Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $1,819.70 | Professional | None | $660.69 | $1,122.02 | $1,819.70 |
Security Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $436.52 Typical High $602.56 | Professional | 53 · Discontinued | $269.15 | $436.52 | $602.56 |
Select Health Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $1,445.44 | Facility | None | $346.74 | $389.05 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $147.91 Median $263.03 Typical High $426.58 | Professional | None | $147.91 | $263.03 | $426.58 |
Select Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $125.89 Typical High $208.93 | Professional | 53 · Discontinued | $74.13 | $125.89 | $208.93 |
Sentara Setting Facility Modifier None Typical Low $165.96 Median $426.58 Typical High $3,162.28 | Facility | None | $165.96 | $426.58 | $3,162.28 |
Sentara Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $616.60 | Professional | None | $323.59 | $436.52 | $616.60 |
Sentara Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $190.55 Typical High $316.23 | Professional | 53 · Discontinued | $147.91 | $190.55 | $316.23 |
SummaCare Setting Facility Modifier None Typical Low $263.03 Median $288.40 Typical High $676.08 | Facility | None | $263.03 | $288.40 | $676.08 |
SummaCare Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $478.63 | Professional | None | $169.82 | $371.54 | $478.63 |
SummaCare Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $128.82 Typical High $218.78 | Professional | 53 · Discontinued | $85.11 | $128.82 | $218.78 |
Sutter Health Plus Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Sutter Health Plus Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $1,096.48 | Professional | None | $602.56 | $602.56 | $1,096.48 |
Sutter Health Plus Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $549.54 | Professional | 53 · Discontinued | $302.00 | $302.00 | $549.54 |
The Alliance Setting Professional Modifier None Typical Low $575.44 Median $1,258.93 Typical High $2,238.72 | Professional | None | $575.44 | $1,258.93 | $2,238.72 |
The Alliance Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $371.54 Typical High $630.96 | Professional | 53 · Discontinued | $218.78 | $371.54 | $630.96 |
Tufts Setting Facility Modifier None Typical Low $89.13 Median $363.08 Typical High $4,677.35 | Facility | None | $89.13 | $363.08 | $4,677.35 |
Tufts Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $194.98 | Professional | None | $85.11 | $117.49 | $194.98 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $131.83 Median $281.84 Typical High $645.65 | Professional | None | $131.83 | $281.84 | $645.65 |
UPMC Health Plan Setting Facility Modifier None Typical Low $288.40 Median $1,096.48 Typical High $2,511.89 | Facility | None | $288.40 | $1,096.48 | $2,511.89 |
UPMC Health Plan Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $446.68 | Professional | None | $177.83 | $323.59 | $446.68 |
UPMC Health Plan Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $288.40 Typical High $436.52 | Professional | 53 · Discontinued | $89.13 | $288.40 | $436.52 |
United Setting Facility Modifier None Typical Low $436.52 Median $870.96 Typical High $3,981.07 | Facility | None | $436.52 | $870.96 | $3,981.07 |
United Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $562.34 | Professional | None | $158.49 | $295.12 | $562.34 |
United Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $102.33 Typical High $151.36 | Professional | 53 · Discontinued | $47.86 | $102.33 | $151.36 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $316.23 Typical High $1,202.26 | Facility | None | $138.04 | $316.23 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $812.83 | Professional | None | $295.12 | $346.74 | $812.83 |
Univera Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $181.97 Typical High $588.84 | Professional | 53 · Discontinued | $107.15 | $181.97 | $588.84 |
University Health Alliance Setting Professional Modifier None Typical Low $58.88 Median $251.19 Typical High $467.74 | Professional | None | $58.88 | $251.19 | $467.74 |
University Health Alliance Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $125.89 Typical High $269.15 | Professional | 53 · Discontinued | $29.51 | $125.89 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $316.23 Typical High $446.68 | Facility | None | $162.18 | $316.23 | $446.68 |
Well Sense Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $354.81 | Professional | None | $158.49 | $239.88 | $354.81 |
Well Sense Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $38.90 | Professional | 53 · Discontinued | $25.70 | $25.70 | $38.90 |
Wellmark Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $933.25 | Professional | None | $363.08 | $416.87 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $380.19 Typical High $380.19 | Professional | None | $302.00 | $380.19 | $380.19 |
Wellpoint Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $190.55 Typical High $281.84 | Professional | 53 · Discontinued | $128.82 | $190.55 | $281.84 |
79 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 33 · Preventive service Typical Low $954.99 Median $1,862.09 Typical High $2,511.89 | Facility | 33 · Preventive service | $954.99 | $1,862.09 | $2,511.89 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $85.11 Median $158.49 Typical High $251.19 | Facility | 52 · Reduced service | $85.11 | $158.49 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $323.59 | Facility | 54 · Surgery only | $128.82 | $234.42 | $323.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $47.86 Typical High $64.57 | Facility | 55 · Aftercare only | $25.70 | $47.86 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $31.62 Typical High $43.65 | Facility | 56 · Pre-op care only | $16.98 | $31.62 | $43.65 |
Aetna Setting Facility Modifier 74 · Stopped after anesthesia Typical Low $1,621.81 Median $4,168.69 Typical High $4,897.79 | Facility | 74 · Stopped after anesthesia | $1,621.81 | $4,168.69 | $4,897.79 |
Aetna Setting Facility Modifier PT · Screening turned treatment Typical Low $1,047.13 Median $2,137.96 Typical High $5,128.61 | Facility | PT · Screening turned treatment | $1,047.13 | $2,137.96 | $5,128.61 |
Aetna Setting Professional Modifier 33 · Preventive service Typical Low $630.96 Median $776.25 Typical High $891.25 | Professional | 33 · Preventive service | $630.96 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $154.88 Typical High $218.78 | Professional | 52 · Reduced service | $89.13 | $154.88 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $218.78 Typical High $323.59 | Professional | 54 · Surgery only | $134.90 | $218.78 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $44.67 Typical High $64.57 | Professional | 55 · Aftercare only | $26.92 | $44.67 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $29.51 Typical High $43.65 | Professional | 56 · Pre-op care only | $18.20 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 74 · Stopped after anesthesia Typical Low $426.58 Median $776.25 Typical High $933.25 | Professional | 74 · Stopped after anesthesia | $426.58 | $776.25 | $933.25 |
Aetna Setting Professional Modifier PT · Screening turned treatment Typical Low $75.86 Median $776.25 Typical High $1,202.26 | Professional | PT · Screening turned treatment | $75.86 | $776.25 | $1,202.26 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $147.91 Median $173.78 Typical High $363.08 | Professional | 33 · Preventive service | $147.91 | $173.78 | $363.08 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $81.28 Median $162.18 Typical High $309.03 | Professional | 51 · Multiple procedures | $81.28 | $162.18 | $309.03 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $81.28 Typical High $91.20 | Professional | 52 · Reduced service | $39.81 | $81.28 | $91.20 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $154.88 Median $162.18 Typical High $346.74 | Professional | 59 · Distinct service | $154.88 | $162.18 | $346.74 |
Ambetter Setting Professional Modifier 74 · Stopped after anesthesia Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 74 · Stopped after anesthesia | $162.18 | $162.18 | $162.18 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $147.91 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $112.20 Median $295.12 Typical High $295.12 | Professional | 79 · Unrelated procedure after surgery | $112.20 | $295.12 | $295.12 |
Ambetter Setting Professional Modifier AG · Primary physician Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | AG · Primary physician | $173.78 | $173.78 | $173.78 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $177.83 Median $194.98 Typical High $245.47 | Professional | GC · Resident with teaching physician | $177.83 | $194.98 | $245.47 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $141.25 Median $147.91 Typical High $575.44 | Professional | KX · Policy requirements met | $141.25 | $147.91 | $575.44 |
Ambetter Setting Professional Modifier PT · Screening turned treatment Typical Low $141.25 Median $162.18 Typical High $223.87 | Professional | PT · Screening turned treatment | $141.25 | $162.18 | $223.87 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $218.78 Median $371.54 Typical High $588.84 | Professional | Q6 · Substitute physician, paid per time | $218.78 | $371.54 | $588.84 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | XU · Unusual separate service | $109.65 | $109.65 | $109.65 |
BCBS Alabama Setting Professional Modifier 32 · Mandated service Typical Low $79.43 Median $138.04 Typical High $436.52 | Professional | 32 · Mandated service | $79.43 | $138.04 | $436.52 |
BCBS Idaho Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $323.59 Typical High $724.44 | Professional | 54 · Surgery only | $275.42 | $323.59 | $724.44 |
BCBS Idaho Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $36.31 Typical High $79.43 | Professional | 55 · Aftercare only | $29.51 | $36.31 | $79.43 |
BCBS Idaho Setting Professional Modifier 63 · Small infant Typical Low $398.11 Median $676.08 Typical High $977.24 | Professional | 63 · Small infant | $398.11 | $676.08 | $977.24 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $524.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $245.47 | $524.81 | $562.34 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $223.87 Typical High $389.05 | Professional | 52 · Reduced service | $204.17 | $223.87 | $389.05 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $48.98 | $151.36 | $204.17 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $245.47 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $398.11 Median $630.96 Typical High $1,071.52 | Professional | 22 · Increased work | $398.11 | $630.96 | $1,071.52 |
BCBS North Dakota Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $363.08 Typical High $616.60 | Professional | 54 · Surgery only | $229.09 | $363.08 | $616.60 |
BCBS North Dakota Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $660.69 |
DeanCare Setting Professional Modifier 51 · Multiple procedures Typical Low $158.49 Median $295.12 Typical High $446.68 | Professional | 51 · Multiple procedures | $158.49 | $295.12 | $446.68 |
Fidelis Setting Professional Modifier 33 · Preventive service Typical Low $165.96 Median $169.82 Typical High $398.11 | Professional | 33 · Preventive service | $165.96 | $169.82 | $398.11 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 59 · Distinct service | $389.05 | $389.05 | $389.05 |
Health Alliance Plan Setting Facility Modifier 33 · Preventive service Typical Low $891.25 Median $2,511.89 Typical High $4,365.16 | Facility | 33 · Preventive service | $891.25 | $2,511.89 | $4,365.16 |
Health Alliance Plan Setting Professional Modifier 33 · Preventive service Typical Low $204.17 Median $436.52 Typical High $2,511.89 | Professional | 33 · Preventive service | $204.17 | $436.52 | $2,511.89 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $154.88 Typical High $213.80 | Professional | 52 · Reduced service | $117.49 | $154.88 | $213.80 |
Health Alliance Plan Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $208.93 Typical High $316.23 | Professional | 54 · Surgery only | $173.78 | $208.93 | $316.23 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $41.69 Typical High $63.10 | Professional | 55 · Aftercare only | $34.67 | $41.69 | $63.10 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $27.54 Typical High $42.66 | Professional | 56 · Pre-op care only | $23.44 | $27.54 | $42.66 |
HealthNet Setting Professional Modifier 33 · Preventive service Typical Low $239.88 Median $1,698.24 Typical High $1,698.24 | Professional | 33 · Preventive service | $239.88 | $1,698.24 | $1,698.24 |
Highmark BCBS Setting Facility Modifier 33 · Preventive service Typical Low $812.83 Median $1,862.09 Typical High $3,715.35 | Facility | 33 · Preventive service | $812.83 | $1,862.09 | $3,715.35 |
Highmark BCBS Setting Facility Modifier 74 · Stopped after anesthesia Typical Low $724.44 Median $1,479.11 Typical High $3,801.89 | Facility | 74 · Stopped after anesthesia | $724.44 | $1,479.11 | $3,801.89 |
Highmark BCBS Setting Facility Modifier PT · Screening turned treatment Typical Low $812.83 Median $2,290.87 Typical High $4,168.69 | Facility | PT · Screening turned treatment | $812.83 | $2,290.87 | $4,168.69 |
Highmark BCBS Setting Professional Modifier GC · Resident with teaching physician Typical Low $213.80 Median $234.42 Typical High $323.59 | Professional | GC · Resident with teaching physician | $213.80 | $234.42 | $323.59 |
Martin's Point Setting Facility Modifier 33 · Preventive service Typical Low $1,000.00 Median $2,041.74 Typical High $2,398.83 | Facility | 33 · Preventive service | $1,000.00 | $2,041.74 | $2,398.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $107.15 | $169.82 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $234.42 | $275.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $46.77 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.90 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.98 | $30.90 | $37.15 |
Martin's Point Setting Professional Modifier 74 · Stopped after anesthesia Typical Low $851.14 Median $912.01 Typical High $954.99 | Professional | 74 · Stopped after anesthesia | $851.14 | $912.01 | $954.99 |
Medcost Setting Facility Modifier 51 · Multiple procedures Typical Low $223.87 Median $323.59 Typical High $512.86 | Facility | 51 · Multiple procedures | $223.87 | $323.59 | $512.86 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $234.42 Median $251.19 Typical High $302.00 | Professional | 51 · Multiple procedures | $234.42 | $251.19 | $302.00 |
Moda Health Setting Facility Modifier 33 · Preventive service Typical Low $1,445.44 Median $1,905.46 Typical High $5,495.41 | Facility | 33 · Preventive service | $1,445.44 | $1,905.46 | $5,495.41 |
Moda Health Setting Facility Modifier 74 · Stopped after anesthesia Typical Low $776.25 Median $2,570.40 Typical High $4,365.16 | Facility | 74 · Stopped after anesthesia | $776.25 | $2,570.40 | $4,365.16 |
Moda Health Setting Facility Modifier PT · Screening turned treatment Typical Low $954.99 Median $2,884.03 Typical High $5,623.41 | Facility | PT · Screening turned treatment | $954.99 | $2,884.03 | $5,623.41 |
Moda Health Setting Professional Modifier 33 · Preventive service Typical Low $213.80 Median $426.58 Typical High $1,737.80 | Professional | 33 · Preventive service | $213.80 | $426.58 | $1,737.80 |
Moda Health Setting Professional Modifier 51 · Multiple procedures Typical Low $354.81 Median $549.54 Typical High $831.76 | Professional | 51 · Multiple procedures | $354.81 | $549.54 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $138.04 Typical High $269.15 | Professional | 52 · Reduced service | $93.33 | $138.04 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $251.19 Typical High $407.38 | Professional | 54 · Surgery only | $131.83 | $251.19 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $50.12 Typical High $81.28 | Professional | 55 · Aftercare only | $26.30 | $50.12 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $33.88 Typical High $54.95 | Professional | 56 · Pre-op care only | $17.78 | $33.88 | $54.95 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $50.12 Median $363.08 Typical High $363.08 | Professional | 59 · Distinct service | $50.12 | $363.08 | $363.08 |
Moda Health Setting Professional Modifier 74 · Stopped after anesthesia Typical Low $323.59 Median $676.08 Typical High $891.25 | Professional | 74 · Stopped after anesthesia | $323.59 | $676.08 | $891.25 |
Moda Health Setting Professional Modifier PT · Screening turned treatment Typical Low $190.55 Median $275.42 Typical High $275.42 | Professional | PT · Screening turned treatment | $190.55 | $275.42 | $275.42 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $1,047.13 | Professional | 54 · Surgery only | $562.34 | $562.34 | $1,047.13 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $151.36 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $151.36 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $1,122.02 |
Qualchoice Setting Professional Modifier 33 · Preventive service Typical Low $281.84 Median $389.05 Typical High $630.96 | Professional | 33 · Preventive service | $281.84 | $389.05 | $630.96 |
United Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $204.17 Typical High $338.84 | Professional | 54 · Surgery only | $102.33 | $204.17 | $338.84 |
Well Sense Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $154.88 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $102.33 | $154.88 | $234.42 |
Well Sense Setting Professional Modifier Q3 · Living kidney donor Typical Low $208.93 Median $208.93 Typical High $281.84 | Professional | Q3 · Living kidney donor | $208.93 | $208.93 | $281.84 |
What it costs in each state
The same service costs 4.5 times more in Vermont than in Maryland. 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.
VT $3,904MD $860
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.