Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.
| Insurance Carrier | Facility/Professional | Modifier | Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. | MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. | Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High. |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier Global Typical Low $891.25 Median $5,754.40 Typical High $12,022.64 | Facility | Global | $891.25 | $5,754.40 | $12,022.64 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $251.19 | Facility | 53 · Discontinued | $151.36 | $169.82 | $251.19 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $933.25 | Facility | 54 · Surgery only | $562.34 | $660.69 | $933.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $186.21 | Facility | 55 · Aftercare only | $112.20 | $128.82 | $186.21 |
Aetna Setting Professional Modifier Global Typical Low $602.56 Median $794.33 Typical High $1,905.46 | Professional | Global | $602.56 | $794.33 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $123.03 Typical High $288.40 | Professional | 55 · Aftercare only | $91.20 | $123.03 | $288.40 |
Anthem BCBS Setting Facility Modifier Global Typical Low $4,073.80 Median $7,762.47 Typical High $13,489.63 | Facility | Global | $4,073.80 | $7,762.47 | $13,489.63 |
Anthem BCBS Setting Professional Modifier Global Typical Low $524.81 Median $660.69 Typical High $1,737.80 | Professional | Global | $524.81 | $660.69 | $1,737.80 |
CDPHP Setting Facility Modifier Global Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | Global | $954.99 | $954.99 | $954.99 |
CDPHP Setting Professional Modifier Global Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | Global | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier Global Typical Low $34.67 Median $1,023.29 Typical High $5,248.07 | Facility | Global | $34.67 | $1,023.29 | $5,248.07 |
Cigna Setting Facility Modifier 22 · Increased work Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | 22 · Increased work | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | 54 · Surgery only | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | 55 · Aftercare only | $151.36 | $151.36 | $151.36 |
Cigna Setting Professional Modifier Global Typical Low $562.34 Median $1,023.29 Typical High $2,818.38 | Professional | Global | $562.34 | $1,023.29 | $2,818.38 |
Emblem Health Setting Facility Modifier Global Typical Low $660.69 Median $870.96 Typical High $2,238.72 | Facility | Global | $660.69 | $870.96 | $2,238.72 |
Emblem Health Setting Professional Modifier Global Typical Low $660.69 Median $812.83 Typical High $1,148.15 | Professional | Global | $660.69 | $812.83 | $1,148.15 |
Excellus BCBS Setting Professional Modifier Global Typical Low $467.74 Median $724.44 Typical High $1,445.44 | Professional | Global | $467.74 | $724.44 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $173.78 Typical High $288.40 | Professional | 55 · Aftercare only | $107.15 | $173.78 | $288.40 |
Highmark BCBS Setting Facility Modifier Global Typical Low $6,025.60 Median $6,025.60 Typical High $7,079.46 | Facility | Global | $6,025.60 | $6,025.60 | $7,079.46 |
Highmark BCBS Setting Professional Modifier Global Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | Global | $676.08 | $676.08 | $691.83 |
MVP Health Care Setting Facility Modifier Global Typical Low $812.83 Median $50,118.72 Typical High $75,857.76 | Facility | Global | $812.83 | $50,118.72 | $75,857.76 |
MVP Health Care Setting Professional Modifier Global Typical Low $398.11 Median $851.14 Typical High $1,778.28 | Professional | Global | $398.11 | $851.14 | $1,778.28 |
United Setting Facility Modifier Global Typical Low $2,398.83 Median $5,495.41 Typical High $13,182.57 | Facility | Global | $2,398.83 | $5,495.41 | $13,182.57 |
United Setting Professional Modifier Global Typical Low $575.44 Median $831.76 Typical High $1,905.46 | Professional | Global | $575.44 | $831.76 | $1,905.46 |
Univera Setting Facility Modifier Global Typical Low $549.54 Median $851.14 Typical High $954.99 | Facility | Global | $549.54 | $851.14 | $954.99 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $446.68 Median $588.84 Typical High $741.31 | Facility | 54 · Surgery only | $446.68 | $588.84 | $741.31 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $109.65 Median $147.91 Typical High $186.21 | Facility | 55 · Aftercare only | $109.65 | $147.91 | $186.21 |
Univera Setting Professional Modifier Global Typical Low $478.63 Median $741.31 Typical High $1,445.44 | Professional | Global | $478.63 | $741.31 | $1,445.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $151.36 Typical High $288.40 | Professional | 55 · Aftercare only | $93.33 | $151.36 | $288.40 |