How much rates vary
Facilitymedian $724 · 10th to 90th $200 to $2,692Professionalmedian $245 · 10th to 90th $87 to $708
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 $275.42 Median $1,445.44 Typical High $3,162.28 | Facility | None | $275.42 | $1,445.44 | $3,162.28 |
Aetna Setting Facility Modifier 26 · Professional part Typical Low $69.18 Median $107.15 Typical High $181.97 | Facility | 26 · Professional part | $69.18 | $107.15 | $181.97 |
Aetna Setting Facility Modifier TC · Technical part Typical Low $128.82 Median $257.04 Typical High $691.83 | Facility | TC · Technical part | $128.82 | $257.04 | $691.83 |
Aetna Setting Professional Modifier None (both parts) Typical Low $208.93 Median $389.05 Typical High $630.96 | Professional | None (both parts) | $208.93 | $389.05 | $630.96 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $114.82 Typical High $181.97 | Professional | 26 · Professional part | $70.79 | $114.82 | $181.97 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $134.90 Median $257.04 Typical High $436.52 | Professional | TC · Technical part | $134.90 | $257.04 | $436.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $173.78 Median $691.83 Typical High $851.14 | Facility | None | $173.78 | $691.83 | $851.14 |
AllWays Health Partners Setting Facility Modifier 26 · Professional part Typical Low $61.66 Median $269.15 Typical High $281.84 | Facility | 26 · Professional part | $61.66 | $269.15 | $281.84 |
AllWays Health Partners Setting Facility Modifier TC · Technical part Typical Low $112.20 Median $537.03 Typical High $562.34 | Facility | TC · Technical part | $112.20 | $537.03 | $562.34 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $229.09 Median $676.08 Typical High $3,235.94 | Professional | None (both parts) | $229.09 | $676.08 | $3,235.94 |
AllWays Health Partners Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $190.55 Typical High $602.56 | Professional | 26 · Professional part | $70.79 | $190.55 | $602.56 |
AllWays Health Partners Setting Professional Modifier TC · Technical part Typical Low $154.88 Median $489.78 Typical High $2,884.03 | Professional | TC · Technical part | $154.88 | $489.78 | $2,884.03 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $128.82 Median $165.96 Typical High $295.12 | Professional | None (both parts) | $128.82 | $165.96 | $295.12 |
Ambetter Setting Professional Modifier 26 · Professional part Typical Low $52.48 Median $69.18 Typical High $120.23 | Professional | 26 · Professional part | $52.48 | $69.18 | $120.23 |
Ambetter Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $125.89 Typical High $208.93 | Professional | TC · Technical part | $89.13 | $125.89 | $208.93 |
AmeriHealth Setting Facility Modifier None Typical Low $660.69 Median $741.31 Typical High $6,606.93 | Facility | None | $660.69 | $741.31 | $6,606.93 |
AmeriHealth Setting Facility Modifier TC · Technical part Typical Low $562.34 Median $1,230.27 Typical High $3,311.31 | Facility | TC · Technical part | $562.34 | $1,230.27 | $3,311.31 |
AmeriHealth Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $912.01 | Professional | None (both parts) | $263.03 | $263.03 | $912.01 |
AmeriHealth Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $87.10 Typical High $426.58 | Professional | 26 · Professional part | $83.18 | $87.10 | $426.58 |
AmeriHealth Setting Professional Modifier TC · Technical part Typical Low $89.13 Median $89.13 Typical High $173.78 | Professional | TC · Technical part | $89.13 | $89.13 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $537.03 Typical High $1,023.29 | Facility | None | $194.98 | $537.03 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $194.98 Median $251.19 Typical High $707.95 | Professional | None (both parts) | $194.98 | $251.19 | $707.95 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $64.57 Median $79.43 Typical High $147.91 | Professional | 26 · Professional part | $64.57 | $79.43 | $147.91 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $128.82 Median $165.96 Typical High $588.84 | Professional | TC · Technical part | $128.82 | $165.96 | $588.84 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $144.54 Median $645.65 Typical High $1,412.54 | Facility | None | $144.54 | $645.65 | $1,412.54 |
Asuris Northwest Health Setting Professional Modifier None (both parts) Typical Low $275.42 Median $3,235.94 Typical High $3,235.94 | Professional | None (both parts) | $275.42 | $3,235.94 | $3,235.94 |
Asuris Northwest Health Setting Professional Modifier 26 · Professional part Typical Low $97.72 Median $199.53 Typical High $602.56 | Professional | 26 · Professional part | $97.72 | $199.53 | $602.56 |
Asuris Northwest Health Setting Professional Modifier TC · Technical part Typical Low $181.97 Median $363.08 Typical High $2,884.03 | Professional | TC · Technical part | $181.97 | $363.08 | $2,884.03 |
Aultcare Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aultcare Setting Professional Modifier None (both parts) Typical Low $208.93 Median $208.93 Typical High $363.08 | Professional | None (both parts) | $208.93 | $208.93 | $363.08 |
AvMed Setting Facility Modifier None Typical Low $83.18 Median $158.49 Typical High $288.40 | Facility | None | $83.18 | $158.49 | $288.40 |
AvMed Setting Professional Modifier None (both parts) Typical Low $100.00 Median $128.82 Typical High $354.81 | Professional | None (both parts) | $100.00 | $128.82 | $354.81 |
BCBS Alabama Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
BCBS Arizona Setting Facility Modifier None Typical Low $117.49 Median $524.81 Typical High $812.83 | Facility | None | $117.49 | $524.81 | $812.83 |
BCBS Arizona Setting Professional Modifier None (both parts) Typical Low $218.78 Median $218.78 Typical High $416.87 | Professional | None (both parts) | $218.78 | $218.78 | $416.87 |
BCBS Arizona Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $70.79 Typical High $134.90 | Professional | 26 · Professional part | $70.79 | $70.79 | $134.90 |
BCBS Arizona Setting Professional Modifier TC · Technical part Typical Low $147.91 Median $147.91 Typical High $281.84 | Professional | TC · Technical part | $147.91 | $147.91 | $281.84 |
BCBS Arkansas Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $309.03 | Facility | None | $223.87 | $223.87 | $309.03 |
BCBS Arkansas Setting Professional Modifier None (both parts) Typical Low $245.47 Median $245.47 Typical High $309.03 | Professional | None (both parts) | $245.47 | $245.47 | $309.03 |
BCBS Arkansas Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $87.10 Typical High $112.20 | Professional | 26 · Professional part | $87.10 | $87.10 | $112.20 |
BCBS Arkansas Setting Professional Modifier TC · Technical part Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | TC · Technical part | $154.88 | $154.88 | $199.53 |
BCBS Idaho Setting Facility Modifier None Typical Low $446.68 Median $1,000.00 Typical High $1,737.80 | Facility | None | $446.68 | $1,000.00 | $1,737.80 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $316.23 Median $371.54 Typical High $446.68 | Professional | None (both parts) | $316.23 | $371.54 | $446.68 |
BCBS Idaho Setting Professional Modifier 26 · Professional part Typical Low $114.82 Median $134.90 Typical High $165.96 | Professional | 26 · Professional part | $114.82 | $134.90 | $165.96 |
BCBS Idaho Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $234.42 Typical High $281.84 | Professional | TC · Technical part | $199.53 | $234.42 | $281.84 |
BCBS Illinois Setting Facility Modifier None Typical Low $346.74 Median $1,412.54 Typical High $3,311.31 | Facility | None | $346.74 | $1,412.54 | $3,311.31 |
BCBS Illinois Setting Professional Modifier None (both parts) Typical Low $91.20 Median $229.09 Typical High $467.74 | Professional | None (both parts) | $91.20 | $229.09 | $467.74 |
BCBS Kansas Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $549.54 | Facility | None | $524.81 | $537.03 | $549.54 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None (both parts) | $446.68 | $446.68 | $446.68 |
BCBS Kansas City Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $1,318.26 | Facility | None | $489.78 | $575.44 | $1,318.26 |
BCBS Kansas City Setting Professional Modifier None (both parts) Typical Low $204.17 Median $208.93 Typical High $309.03 | Professional | None (both parts) | $204.17 | $208.93 | $309.03 |
BCBS Kansas City Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $77.62 Typical High $100.00 | Professional | 26 · Professional part | $74.13 | $77.62 | $100.00 |
BCBS Kansas City Setting Professional Modifier TC · Technical part Typical Low $128.82 Median $131.83 Typical High $199.53 | Professional | TC · Technical part | $128.82 | $131.83 | $199.53 |
BCBS Louisiana Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $933.25 | Facility | None | $288.40 | $562.34 | $933.25 |
BCBS Louisiana Setting Professional Modifier None (both parts) Typical Low $263.03 Median $281.84 Typical High $354.81 | Professional | None (both parts) | $263.03 | $281.84 | $354.81 |
BCBS Louisiana Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 26 · Professional part | $83.18 | $91.20 | $104.71 |
BCBS Louisiana Setting Professional Modifier TC · Technical part Typical Low $177.83 Median $190.55 Typical High $251.19 | Professional | TC · Technical part | $177.83 | $190.55 | $251.19 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $354.81 Median $660.69 Typical High $1,023.29 | Facility | None | $354.81 | $660.69 | $1,023.29 |
BCBS Massachusetts Setting Professional Modifier None (both parts) Typical Low $371.54 Median $549.54 Typical High $691.83 | Professional | None (both parts) | $371.54 | $549.54 | $691.83 |
BCBS Massachusetts Setting Professional Modifier 26 · Professional part Typical Low $75.86 Median $75.86 Typical High $128.82 | Professional | 26 · Professional part | $75.86 | $75.86 | $128.82 |
BCBS Michigan Setting Facility Modifier None Typical Low $204.17 Median $302.00 Typical High $524.81 | Facility | None | $204.17 | $302.00 | $524.81 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $190.55 Median $295.12 Typical High $316.23 | Professional | None (both parts) | $190.55 | $295.12 | $316.23 |
BCBS Michigan Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 26 · Professional part | $112.20 | $112.20 | $112.20 |
BCBS Michigan Setting Professional Modifier TC · Technical part Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | TC · Technical part | $204.17 | $204.17 | $204.17 |
BCBS Minnesota Setting Facility Modifier None Typical Low $457.09 Median $977.24 Typical High $1,288.25 | Facility | None | $457.09 | $977.24 | $1,288.25 |
BCBS Minnesota Setting Professional Modifier None (both parts) Typical Low $316.23 Median $407.38 Typical High $616.60 | Professional | None (both parts) | $316.23 | $407.38 | $616.60 |
BCBS Minnesota Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $147.91 Typical High $218.78 | Professional | 26 · Professional part | $112.20 | $147.91 | $218.78 |
BCBS Minnesota Setting Professional Modifier TC · Technical part Typical Low $204.17 Median $281.84 Typical High $407.38 | Professional | TC · Technical part | $204.17 | $281.84 | $407.38 |
BCBS Mississippi Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $478.63 | Facility | None | $426.58 | $426.58 | $478.63 |
BCBS Mississippi Setting Professional Modifier None (both parts) Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None (both parts) | $501.19 | $501.19 | $501.19 |
BCBS Montana Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Facility | None | $524.81 | $524.81 | $1,445.44 |
BCBS Montana Setting Professional Modifier None (both parts) Typical Low $109.65 Median $109.65 Typical High $309.03 | Professional | None (both parts) | $109.65 | $109.65 | $309.03 |
BCBS Nebraska Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $2,041.74 | Facility | None | $831.76 | $1,995.26 | $2,041.74 |
BCBS Nebraska Setting Professional Modifier 26 · Professional part Typical Low $120.23 Median $125.89 Typical High $131.83 | Professional | 26 · Professional part | $120.23 | $125.89 | $131.83 |
BCBS Nebraska Setting Professional Modifier TC · Technical part Typical Low $199.53 Median $218.78 Typical High $234.42 | Professional | TC · Technical part | $199.53 | $218.78 | $234.42 |
BCBS New Mexico Setting Facility Modifier None Typical Low $524.81 Median $1,862.09 Typical High $2,884.03 | Facility | None | $524.81 | $1,862.09 | $2,884.03 |
BCBS New Mexico Setting Professional Modifier None (both parts) Typical Low $50.12 Median $134.90 Typical High $218.78 | Professional | None (both parts) | $50.12 | $134.90 | $218.78 |
BCBS North Carolina Setting Facility Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,584.89 | Facility | None | $891.25 | $1,412.54 | $1,584.89 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None (both parts) | $186.21 | $186.21 | $186.21 |
BCBS North Carolina Setting Professional Modifier 26 · Professional part Typical Low $117.49 Median $169.82 Typical High $223.87 | Professional | 26 · Professional part | $117.49 | $169.82 | $223.87 |
BCBS North Carolina Setting Professional Modifier TC · Technical part Typical Low $346.74 Median $616.60 Typical High $912.01 | Professional | TC · Technical part | $346.74 | $616.60 | $912.01 |
BCBS North Dakota Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,778.28 | Facility | None | $933.25 | $1,258.93 | $1,778.28 |
BCBS North Dakota Setting Professional Modifier None (both parts) Typical Low $338.84 Median $436.52 Typical High $512.86 | Professional | None (both parts) | $338.84 | $436.52 | $512.86 |
BCBS North Dakota Setting Professional Modifier 26 · Professional part Typical Low $120.23 Median $154.88 Typical High $181.97 | Professional | 26 · Professional part | $120.23 | $154.88 | $181.97 |
BCBS North Dakota Setting Professional Modifier TC · Technical part Typical Low $218.78 Median $281.84 Typical High $331.13 | Professional | TC · Technical part | $218.78 | $281.84 | $331.13 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $389.05 Median $537.03 Typical High $758.58 | Facility | None | $389.05 | $537.03 | $758.58 |
BCBS Oklahoma Setting Professional Modifier None (both parts) Typical Low $70.79 Median $194.98 Typical High $269.15 | Professional | None (both parts) | $70.79 | $194.98 | $269.15 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $338.84 Median $380.19 Typical High $588.84 | Facility | None | $338.84 | $380.19 | $588.84 |
BCBS Rhode Island Setting Professional Modifier None (both parts) Typical Low $213.80 Median $281.84 Typical High $676.08 | Professional | None (both parts) | $213.80 | $281.84 | $676.08 |
BCBS Rhode Island Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $100.00 Typical High $125.89 | Professional | 26 · Professional part | $70.79 | $100.00 | $125.89 |
BCBS Rhode Island Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $154.88 Typical High $181.97 | Professional | TC · Technical part | $125.89 | $154.88 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $2,290.87 | Facility | None | $660.69 | $1,380.38 | $2,290.87 |
BCBS South Carolina Setting Facility Modifier TC · Technical part Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | TC · Technical part | $660.69 | $660.69 | $660.69 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $181.97 Median $457.09 Typical High $645.65 | Professional | None (both parts) | $181.97 | $457.09 | $645.65 |
BCBS South Carolina Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $131.83 Typical High $181.97 | Professional | 26 · Professional part | $66.07 | $131.83 | $181.97 |
BCBS South Carolina Setting Professional Modifier TC · Technical part Typical Low $114.82 Median $331.13 Typical High $436.52 | Professional | TC · Technical part | $114.82 | $331.13 | $436.52 |
BCBS Tennessee Setting Professional Modifier None (both parts) Typical Low $151.36 Median $269.15 Typical High $616.60 | Professional | None (both parts) | $151.36 | $269.15 | $616.60 |
BCBS Tennessee Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $89.13 Typical High $154.88 | Professional | 26 · Professional part | $66.07 | $89.13 | $154.88 |
BCBS Tennessee Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $190.55 Typical High $489.78 | Professional | TC · Technical part | $123.03 | $190.55 | $489.78 |
BCBS Texas Setting Facility Modifier None Typical Low $257.04 Median $870.96 Typical High $1,737.80 | Facility | None | $257.04 | $870.96 | $1,737.80 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $54.95 Median $151.36 Typical High $288.40 | Professional | None (both parts) | $54.95 | $151.36 | $288.40 |
BCBS Vermont Setting Facility Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,344.23 | $3,162.28 | $4,677.35 |
BCBS Vermont Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $851.14 | Professional | None (both parts) | $269.15 | $269.15 | $851.14 |
BCBS Wyoming Setting Professional Modifier None (both parts) Typical Low $501.19 Median $776.25 Typical High $1,479.11 | Professional | None (both parts) | $501.19 | $776.25 | $1,479.11 |
BCBS Wyoming Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $275.42 Typical High $524.81 | Professional | 26 · Professional part | $177.83 | $275.42 | $524.81 |
BCBS Wyoming Setting Professional Modifier TC · Technical part Typical Low $323.59 Median $489.78 Typical High $933.25 | Professional | TC · Technical part | $323.59 | $489.78 | $933.25 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $181.97 Median $190.55 Typical High $316.23 | Professional | None (both parts) | $181.97 | $190.55 | $316.23 |
Blue Shield Setting Facility Modifier None Typical Low $478.63 Median $3,090.30 Typical High $5,888.44 | Facility | None | $478.63 | $3,090.30 | $5,888.44 |
Blue Shield Setting Professional Modifier None (both parts) Typical Low $186.21 Median $281.84 Typical High $489.78 | Professional | None (both parts) | $186.21 | $281.84 | $489.78 |
Blue Shield Setting Professional Modifier 26 · Professional part Typical Low $61.66 Median $89.13 Typical High $154.88 | Professional | 26 · Professional part | $61.66 | $89.13 | $154.88 |
Blue Shield Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $190.55 Typical High $331.13 | Professional | TC · Technical part | $125.89 | $190.55 | $331.13 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $102.33 Median $194.98 Typical High $295.12 | Professional | None (both parts) | $102.33 | $194.98 | $295.12 |
Capital Blue Cross Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $5,011.87 | Facility | None | $1,230.27 | $5,011.87 | $5,011.87 |
Capital Blue Cross Setting Facility Modifier TC · Technical part Typical Low $1,862.09 Median $2,344.23 Typical High $5,011.87 | Facility | TC · Technical part | $1,862.09 | $2,344.23 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None (both parts) Typical Low $239.88 Median $363.08 Typical High $616.60 | Professional | None (both parts) | $239.88 | $363.08 | $616.60 |
Capital Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $89.13 Median $117.49 Typical High $181.97 | Professional | 26 · Professional part | $89.13 | $117.49 | $181.97 |
Capital Blue Cross Setting Professional Modifier TC · Technical part Typical Low $151.36 Median $234.42 Typical High $537.03 | Professional | TC · Technical part | $151.36 | $234.42 | $537.03 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $87.10 Median $186.21 Typical High $281.84 | Professional | None (both parts) | $87.10 | $186.21 | $281.84 |
CareFirst Setting Professional Modifier 26 · Professional part Typical Low $85.11 Median $95.50 Typical High $114.82 | Professional | 26 · Professional part | $85.11 | $95.50 | $114.82 |
CareFirst Setting Professional Modifier TC · Technical part Typical Low $158.49 Median $213.80 Typical High $676.08 | Professional | TC · Technical part | $158.49 | $213.80 | $676.08 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $123.03 Typical High $239.88 | Facility | None | $66.07 | $123.03 | $239.88 |
CareSource Setting Professional Modifier None (both parts) Typical Low $66.07 Median $120.23 Typical High $229.09 | Professional | None (both parts) | $66.07 | $120.23 | $229.09 |
Central California Alliance for Health Setting Professional Modifier None (both parts) Typical Low $213.80 Median $281.84 Typical High $1,230.27 | Professional | None (both parts) | $213.80 | $281.84 | $1,230.27 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 26 · Professional part | $67.61 | $69.18 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $524.81 Typical High $1,445.44 | Facility | None | $288.40 | $524.81 | $1,445.44 |
Cigna Setting Facility Modifier 26 · Professional part Typical Low $17.38 Median $104.71 Typical High $275.42 | Facility | 26 · Professional part | $17.38 | $104.71 | $275.42 |
Cigna Setting Facility Modifier TC · Technical part Typical Low $52.48 Median $302.00 Typical High $549.54 | Facility | TC · Technical part | $52.48 | $302.00 | $549.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $158.49 Median $331.13 Typical High $776.25 | Professional | None (both parts) | $158.49 | $331.13 | $776.25 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $50.12 Median $83.18 Typical High $173.78 | Professional | 26 · Professional part | $50.12 | $83.18 | $173.78 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $102.33 Median $218.78 Typical High $616.60 | Professional | TC · Technical part | $102.33 | $218.78 | $616.60 |
Community Health Options Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Community Health Options Setting Professional Modifier None (both parts) Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None (both parts) | $229.09 | $229.09 | $229.09 |
ConnectiCare Setting Professional Modifier None (both parts) Typical Low $269.15 Median $512.86 Typical High $707.95 | Professional | None (both parts) | $269.15 | $512.86 | $707.95 |
Contra Costa Health Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $338.84 | Professional | None | $186.21 | $251.19 | $338.84 |
Contra Costa Health Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $79.43 Typical High $107.15 | Professional | 26 · Professional part | $58.88 | $79.43 | $107.15 |
Contra Costa Health Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $173.78 Typical High $234.42 | Professional | TC · Technical part | $125.89 | $173.78 | $234.42 |
DeanCare Setting Facility Modifier None Typical Low $229.09 Median $1,230.27 Typical High $1,737.80 | Facility | None | $229.09 | $1,230.27 | $1,737.80 |
DeanCare Setting Facility Modifier TC · Technical part Typical Low $1,122.02 Median $1,380.38 Typical High $1,737.80 | Facility | TC · Technical part | $1,122.02 | $1,380.38 | $1,737.80 |
DeanCare Setting Professional Modifier None (both parts) Typical Low $354.81 Median $489.78 Typical High $549.54 | Professional | None (both parts) | $354.81 | $489.78 | $549.54 |
DeanCare Setting Professional Modifier 26 · Professional part Typical Low $128.82 Median $177.83 Typical High $194.98 | Professional | 26 · Professional part | $128.82 | $177.83 | $194.98 |
DeanCare Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $309.03 Typical High $346.74 | Professional | TC · Technical part | $229.09 | $309.03 | $346.74 |
Denver HMP Setting Facility Modifier None Typical Low $251.19 Median $512.86 Typical High $758.58 | Facility | None | $251.19 | $512.86 | $758.58 |
Denver HMP Setting Professional Modifier None (both parts) Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None (both parts) | $371.54 | $371.54 | $371.54 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $151.36 Typical High $489.78 | Facility | None | $97.72 | $151.36 | $489.78 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $213.80 Median $229.09 Typical High $346.74 | Professional | None (both parts) | $213.80 | $229.09 | $346.74 |
Emblem Health Setting Professional Modifier 26 · Professional part Typical Low $69.18 Median $79.43 Typical High $128.82 | Professional | 26 · Professional part | $69.18 | $79.43 | $128.82 |
Emblem Health Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $147.91 Typical High $213.80 | Professional | TC · Technical part | $144.54 | $147.91 | $213.80 |
Excellus BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Excellus BCBS Setting Facility Modifier TC · Technical part Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | TC · Technical part | $302.00 | $302.00 | $302.00 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $181.97 Median $213.80 Typical High $331.13 | Professional | None (both parts) | $181.97 | $213.80 | $331.13 |
Excellus BCBS Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $66.07 Typical High $117.49 | Professional | 26 · Professional part | $33.11 | $66.07 | $117.49 |
Excellus BCBS Setting Professional Modifier TC · Technical part Typical Low $114.82 Median $134.90 Typical High $257.04 | Professional | TC · Technical part | $114.82 | $134.90 | $257.04 |
Fallon Health Setting Facility Modifier None Typical Low $87.10 Median $186.21 Typical High $316.23 | Facility | None | $87.10 | $186.21 | $316.23 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $91.20 Median $194.98 Typical High $316.23 | Professional | None (both parts) | $91.20 | $194.98 | $316.23 |
Fidelis Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $97.72 Typical High $104.71 | Professional | 26 · Professional part | $79.43 | $97.72 | $104.71 |
Florida Blue Setting Facility Modifier None Typical Low $489.78 Median $1,258.93 Typical High $2,691.53 | Facility | None | $489.78 | $1,258.93 | $2,691.53 |
Florida Blue Setting Professional Modifier None (both parts) Typical Low $169.82 Median $288.40 Typical High $588.84 | Professional | None (both parts) | $169.82 | $288.40 | $588.84 |
Florida Blue Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $83.18 Typical High $102.33 | Professional | 26 · Professional part | $54.95 | $83.18 | $102.33 |
Florida Blue Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $190.55 Typical High $501.19 | Professional | TC · Technical part | $112.20 | $190.55 | $501.19 |
Geisinger Setting Facility Modifier None Typical Low $630.96 Median $741.31 Typical High $3,981.07 | Facility | None | $630.96 | $741.31 | $3,981.07 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $181.97 Median $338.84 Typical High $630.96 | Professional | None (both parts) | $181.97 | $338.84 | $630.96 |
Geisinger Setting Professional Modifier 26 · Professional part Typical Low $60.26 Median $81.28 Typical High $151.36 | Professional | 26 · Professional part | $60.26 | $81.28 | $151.36 |
Geisinger Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $218.78 Typical High $512.86 | Professional | TC · Technical part | $112.20 | $218.78 | $512.86 |
HMSA Setting Professional Modifier None (both parts) Typical Low $616.60 Median $724.44 Typical High $812.83 | Professional | None (both parts) | $616.60 | $724.44 | $812.83 |
HMSA Setting Professional Modifier 26 · Professional part Typical Low $93.33 Median $95.50 Typical High $100.00 | Professional | 26 · Professional part | $93.33 | $95.50 | $100.00 |
HMSA Setting Professional Modifier TC · Technical part Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | TC · Technical part | $630.96 | $630.96 | $660.69 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $1,949.84 | Professional | None | $194.98 | $316.23 | $1,949.84 |
Hally Health Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $109.65 Typical High $398.11 | Professional | 26 · Professional part | $74.13 | $109.65 | $398.11 |
Hally Health Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $199.53 Typical High $1,548.82 | Professional | TC · Technical part | $125.89 | $199.53 | $1,548.82 |
Hally Health Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Hally Health Setting Professional Modifier None (both parts) Typical Low $229.09 Median $234.42 Typical High $251.19 | Professional | None (both parts) | $229.09 | $234.42 | $251.19 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $229.09 Median $398.11 Typical High $707.95 | Professional | None (both parts) | $229.09 | $398.11 | $707.95 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $75.86 Median $114.82 Typical High $218.78 | Professional | 26 · Professional part | $75.86 | $114.82 | $218.78 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $147.91 Median $245.47 Typical High $478.63 | Professional | TC · Technical part | $147.91 | $245.47 | $478.63 |
Health Alliance Plan Setting Facility Modifier None Typical Low $251.19 Median $1,288.25 Typical High $2,238.72 | Facility | None | $251.19 | $1,288.25 | $2,238.72 |
Health Alliance Plan Setting Facility Modifier 26 · Professional part Typical Low $89.13 Median $91.20 Typical High $169.82 | Facility | 26 · Professional part | $89.13 | $91.20 | $169.82 |
Health Alliance Plan Setting Facility Modifier TC · Technical part Typical Low $151.36 Median $363.08 Typical High $758.58 | Facility | TC · Technical part | $151.36 | $363.08 | $758.58 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $218.78 Median $338.84 Typical High $524.81 | Professional | None (both parts) | $218.78 | $338.84 | $524.81 |
Health Alliance Plan Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $89.13 Typical High $144.54 | Professional | 26 · Professional part | $58.88 | $89.13 | $144.54 |
Health Alliance Plan Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $281.84 Typical High $371.54 | Professional | TC · Technical part | $144.54 | $281.84 | $371.54 |
Health New England Setting Facility Modifier None Typical Low $363.08 Median $1,000.00 Typical High $2,511.89 | Facility | None | $363.08 | $1,000.00 | $2,511.89 |
Health New England Setting Professional Modifier None (both parts) Typical Low $102.33 Median $134.90 Typical High $602.56 | Professional | None (both parts) | $102.33 | $134.90 | $602.56 |
Health Partners Setting Facility Modifier None Typical Low $416.87 Median $660.69 Typical High $1,548.82 | Facility | None | $416.87 | $660.69 | $1,548.82 |
Health Partners Setting Facility Modifier 26 · Professional part Typical Low $144.54 Median $229.09 Typical High $537.03 | Facility | 26 · Professional part | $144.54 | $229.09 | $537.03 |
Health Partners Setting Facility Modifier TC · Technical part Typical Low $269.15 Median $426.58 Typical High $1,000.00 | Facility | TC · Technical part | $269.15 | $426.58 | $1,000.00 |
Health Partners Setting Professional Modifier None (both parts) Typical Low $295.12 Median $354.81 Typical High $812.83 | Professional | None (both parts) | $295.12 | $354.81 | $812.83 |
Health Partners Setting Professional Modifier 26 · Professional part Typical Low $104.71 Median $123.03 Typical High $204.17 | Professional | 26 · Professional part | $104.71 | $123.03 | $204.17 |
Health Partners Setting Professional Modifier TC · Technical part Typical Low $194.98 Median $229.09 Typical High $676.08 | Professional | TC · Technical part | $194.98 | $229.09 | $676.08 |
Health Smart Setting Facility Modifier None Typical Low $269.15 Median $524.81 Typical High $851.14 | Facility | None | $269.15 | $524.81 | $851.14 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $218.78 Median $478.63 Typical High $1,288.25 | Professional | None (both parts) | $218.78 | $478.63 | $1,288.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $1,778.28 | Facility | None | $302.00 | $602.56 | $1,778.28 |
Highmark BCBS Setting Facility Modifier TC · Technical part Typical Low $213.80 Median $616.60 Typical High $1,949.84 | Facility | TC · Technical part | $213.80 | $616.60 | $1,949.84 |
Highmark BCBS Setting Professional Modifier None (both parts) Typical Low $181.97 Median $223.87 Typical High $467.74 | Professional | None (both parts) | $181.97 | $223.87 | $467.74 |
Highmark BCBS Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $91.20 Typical High $134.90 | Professional | 26 · Professional part | $74.13 | $91.20 | $134.90 |
Hometown Health Setting Professional Modifier None Typical Low $4.90 Median $302.00 Typical High $426.58 | Professional | None | $4.90 | $302.00 | $426.58 |
Hometown Health Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $81.28 Typical High $120.23 | Professional | 26 · Professional part | $54.95 | $81.28 | $120.23 |
Hometown Health Setting Professional Modifier TC · Technical part Typical Low $4.07 Median $194.98 Typical High $398.11 | Professional | TC · Technical part | $4.07 | $194.98 | $398.11 |
Hometown Health Setting Professional Modifier None (both parts) Typical Low $4.90 Median $4.90 Typical High $288.40 | Professional | None (both parts) | $4.90 | $4.90 | $288.40 |
Horizon BCBS Setting Facility Modifier None Typical Low $457.09 Median $812.83 Typical High $5,888.44 | Facility | None | $457.09 | $812.83 | $5,888.44 |
Horizon BCBS Setting Professional Modifier None (both parts) Typical Low $218.78 Median $257.04 Typical High $446.68 | Professional | None (both parts) | $218.78 | $257.04 | $446.68 |
Horizon BCBS Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $81.28 Typical High $107.15 | Professional | 26 · Professional part | $70.79 | $81.28 | $107.15 |
Horizon BCBS Setting Professional Modifier TC · Technical part Typical Low $151.36 Median $173.78 Typical High $275.42 | Professional | TC · Technical part | $151.36 | $173.78 | $275.42 |
Independence Blue Cross Setting Facility Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $5,011.87 | Facility | None | $1,000.00 | $1,621.81 | $5,011.87 |
Independence Blue Cross Setting Facility Modifier TC · Technical part Typical Low $169.82 Median $1,258.93 Typical High $2,187.76 | Facility | TC · Technical part | $169.82 | $1,258.93 | $2,187.76 |
Independence Blue Cross Setting Professional Modifier None (both parts) Typical Low $263.03 Median $263.03 Typical High $478.63 | Professional | None (both parts) | $263.03 | $263.03 | $478.63 |
Independence Blue Cross Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $87.10 Typical High $173.78 | Professional | 26 · Professional part | $83.18 | $87.10 | $173.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $524.81 | Professional | None | $199.53 | $257.04 | $524.81 |
Kaiser Permanente Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $95.50 Typical High $213.80 | Professional | 26 · Professional part | $70.79 | $95.50 | $213.80 |
Kaiser Permanente Setting Professional Modifier TC · Technical part Typical Low $138.04 Median $190.55 Typical High $467.74 | Professional | TC · Technical part | $138.04 | $190.55 | $467.74 |
Kaiser Permanente Setting Professional Modifier None (both parts) Typical Low $109.65 Median $295.12 Typical High $660.69 | Professional | None (both parts) | $109.65 | $295.12 | $660.69 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None (both parts) | $3,235.94 | $3,235.94 | $3,235.94 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 26 · Professional part | $602.56 | $602.56 | $602.56 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | TC · Technical part | $2,884.03 | $2,884.03 | $2,884.03 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $251.19 Typical High $645.65 | Facility | None | $107.15 | $251.19 | $645.65 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $446.68 Median $446.68 Typical High $549.54 | Professional | None (both parts) | $446.68 | $446.68 | $549.54 |
MVP Health Care Setting Professional Modifier 26 · Professional part Typical Low $75.86 Median $151.36 Typical High $208.93 | Professional | 26 · Professional part | $75.86 | $151.36 | $208.93 |
MVP Health Care Setting Professional Modifier TC · Technical part Typical Low $141.25 Median $371.54 Typical High $512.86 | Professional | TC · Technical part | $141.25 | $371.54 | $512.86 |
Martin's Point Setting Facility Modifier None Typical Low $229.09 Median $549.54 Typical High $1,548.82 | Facility | None | $229.09 | $549.54 | $1,548.82 |
Martin's Point Setting Facility Modifier 26 · Professional part Typical Low $70.79 Median $102.33 Typical High $257.04 | Facility | 26 · Professional part | $70.79 | $102.33 | $257.04 |
Martin's Point Setting Facility Modifier TC · Technical part Typical Low $125.89 Median $177.83 Typical High $977.24 | Facility | TC · Technical part | $125.89 | $177.83 | $977.24 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $199.53 Median $426.58 Typical High $602.56 | Professional | None (both parts) | $199.53 | $426.58 | $602.56 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $125.89 Typical High $165.96 | Professional | 26 · Professional part | $70.79 | $125.89 | $165.96 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $302.00 Typical High $436.52 | Professional | TC · Technical part | $125.89 | $302.00 | $436.52 |
Mass General Brigham Setting Facility Modifier None Typical Low $173.78 Median $691.83 Typical High $851.14 | Facility | None | $173.78 | $691.83 | $851.14 |
Mass General Brigham Setting Facility Modifier 26 · Professional part Typical Low $61.66 Median $269.15 Typical High $281.84 | Facility | 26 · Professional part | $61.66 | $269.15 | $281.84 |
Mass General Brigham Setting Facility Modifier TC · Technical part Typical Low $112.20 Median $537.03 Typical High $562.34 | Facility | TC · Technical part | $112.20 | $537.03 | $562.34 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $229.09 Median $676.08 Typical High $3,235.94 | Professional | None (both parts) | $229.09 | $676.08 | $3,235.94 |
Mass General Brigham Setting Professional Modifier 26 · Professional part Typical Low $70.79 Median $190.55 Typical High $602.56 | Professional | 26 · Professional part | $70.79 | $190.55 | $602.56 |
Mass General Brigham Setting Professional Modifier TC · Technical part Typical Low $154.88 Median $489.78 Typical High $2,884.03 | Professional | TC · Technical part | $154.88 | $489.78 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $870.96 | $870.96 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $104.71 Median $131.83 Typical High $131.83 | Professional | 26 · Professional part | $104.71 | $131.83 | $131.83 |
Medcost Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $1,122.02 | Facility | None | $194.98 | $316.23 | $1,122.02 |
Medcost Setting Professional Modifier None (both parts) Typical Low $251.19 Median $588.84 Typical High $891.25 | Professional | None (both parts) | $251.19 | $588.84 | $891.25 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $95.50 Median $141.25 Typical High $263.03 | Professional | 26 · Professional part | $95.50 | $141.25 | $263.03 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $169.82 Median $489.78 Typical High $588.84 | Professional | TC · Technical part | $169.82 | $489.78 | $588.84 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $1,122.02 Typical High $2,818.38 | Facility | None | $316.23 | $1,122.02 | $2,818.38 |
Medica Setting Facility Modifier 26 · Professional part Typical Low $512.86 Median $660.69 Typical High $660.69 | Facility | 26 · Professional part | $512.86 | $660.69 | $660.69 |
Medica Setting Facility Modifier TC · Technical part Typical Low $1,122.02 Median $1,513.56 Typical High $3,467.37 | Facility | TC · Technical part | $1,122.02 | $1,513.56 | $3,467.37 |
Medica Setting Professional Modifier None (both parts) Typical Low $218.78 Median $660.69 Typical High $3,162.28 | Professional | None (both parts) | $218.78 | $660.69 | $3,162.28 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $69.18 Median $208.93 Typical High $575.44 | Professional | 26 · Professional part | $69.18 | $208.93 | $575.44 |
Medica Setting Professional Modifier TC · Technical part Typical Low $144.54 Median $602.56 Typical High $2,754.23 | Professional | TC · Technical part | $144.54 | $602.56 | $2,754.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $1,258.93 Typical High $2,630.27 | Facility | None | $426.58 | $1,258.93 | $2,630.27 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $162.18 Median $239.88 Typical High $645.65 | Professional | None (both parts) | $162.18 | $239.88 | $645.65 |
Medical Mutual of Ohio Setting Professional Modifier 26 · Professional part Typical Low $61.66 Median $123.03 Typical High $223.87 | Professional | 26 · Professional part | $61.66 | $123.03 | $223.87 |
Medical Mutual of Ohio Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $147.91 Typical High $549.54 | Professional | TC · Technical part | $123.03 | $147.91 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $489.78 | Professional | None | $398.11 | $446.68 | $489.78 |
Midlands Setting Professional Modifier 26 · Professional part Typical Low $144.54 Median $158.49 Typical High $177.83 | Professional | 26 · Professional part | $144.54 | $158.49 | $177.83 |
Midlands Setting Professional Modifier TC · Technical part Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | TC · Technical part | $251.19 | $281.84 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,071.52 | $1,380.38 | $1,380.38 |
Midlands Setting Professional Modifier None (both parts) Typical Low $354.81 Median $478.63 Typical High $758.58 | Professional | None (both parts) | $354.81 | $478.63 | $758.58 |
Midlands Setting Professional Modifier 26 · Professional part Typical Low $128.82 Median $162.18 Typical High $218.78 | Professional | 26 · Professional part | $128.82 | $162.18 | $218.78 |
Midlands Setting Professional Modifier TC · Technical part Typical Low $229.09 Median $302.00 Typical High $630.96 | Professional | TC · Technical part | $229.09 | $302.00 | $630.96 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,548.82 Typical High $2,884.03 | Facility | None | $234.42 | $1,548.82 | $2,884.03 |
Moda Health Setting Facility Modifier 26 · Professional part Typical Low $66.07 Median $107.15 Typical High $269.15 | Facility | 26 · Professional part | $66.07 | $107.15 | $269.15 |
Moda Health Setting Facility Modifier TC · Technical part Typical Low $169.82 Median $691.83 Typical High $2,754.23 | Facility | TC · Technical part | $169.82 | $691.83 | $2,754.23 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $165.96 Median $316.23 Typical High $758.58 | Professional | None (both parts) | $165.96 | $316.23 | $758.58 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $97.72 Typical High $223.87 | Professional | 26 · Professional part | $57.54 | $97.72 | $223.87 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $109.65 Median $186.21 Typical High $457.09 | Professional | TC · Technical part | $109.65 | $186.21 | $457.09 |
Molina Setting Professional Modifier None (both parts) Typical Low $23.44 Median $125.89 Typical High $275.42 | Professional | None (both parts) | $23.44 | $125.89 | $275.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $89.13 Median $323.59 Typical High $398.11 | Facility | None | $89.13 | $323.59 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $58.88 Median $213.80 Typical High $467.74 | Professional | None (both parts) | $58.88 | $213.80 | $467.74 |
Network Health Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $758.58 | Facility | None | $316.23 | $316.23 | $758.58 |
Network Health Setting Professional Modifier None (both parts) Typical Low $295.12 Median $794.33 Typical High $870.96 | Professional | None (both parts) | $295.12 | $794.33 | $870.96 |
Network Health Setting Professional Modifier 26 · Professional part Typical Low $100.00 Median $147.91 Typical High $281.84 | Professional | 26 · Professional part | $100.00 | $147.91 | $281.84 |
Network Health Setting Professional Modifier TC · Technical part Typical Low $194.98 Median $616.60 Typical High $724.44 | Professional | TC · Technical part | $194.98 | $616.60 | $724.44 |
Oscar Health Setting Facility Modifier None Typical Low $239.88 Median $630.96 Typical High $3,311.31 | Facility | None | $239.88 | $630.96 | $3,311.31 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $74.13 Median $177.83 Typical High $354.81 | Professional | None (both parts) | $74.13 | $177.83 | $354.81 |
Pacific Source Setting Facility Modifier None Typical Low $117.49 Median $251.19 Typical High $501.19 | Facility | None | $117.49 | $251.19 | $501.19 |
Pacific Source Setting Professional Modifier None (both parts) Typical Low $147.91 Median $177.83 Typical High $302.00 | Professional | None (both parts) | $147.91 | $177.83 | $302.00 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $489.78 Median $588.84 Typical High $2,089.30 | Facility | None | $489.78 | $588.84 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None (both parts) Typical Low $208.93 Median $275.42 Typical High $398.11 | Professional | None (both parts) | $208.93 | $275.42 | $398.11 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $97.72 Typical High $131.83 | Professional | 26 · Professional part | $79.43 | $97.72 | $131.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier TC · Technical part Typical Low $138.04 Median $173.78 Typical High $251.19 | Professional | TC · Technical part | $138.04 | $173.78 | $251.19 |
Premera BCBS Setting Facility Modifier None Typical Low $229.09 Median $269.15 Typical High $269.15 | Facility | None | $229.09 | $269.15 | $269.15 |
Premera BCBS Setting Professional Modifier None (both parts) Typical Low $269.15 Median $269.15 Typical High $794.33 | Professional | None (both parts) | $269.15 | $269.15 | $794.33 |
Premera BCBS Setting Professional Modifier 26 · Professional part Typical Low $95.50 Median $95.50 Typical High $281.84 | Professional | 26 · Professional part | $95.50 | $95.50 | $281.84 |
Premera BCBS Setting Professional Modifier TC · Technical part Typical Low $173.78 Median $173.78 Typical High $512.86 | Professional | TC · Technical part | $173.78 | $173.78 | $512.86 |
Prevea360 Setting Facility Modifier None Typical Low $204.17 Median $416.87 Typical High $630.96 | Facility | None | $204.17 | $416.87 | $630.96 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $190.55 Median $346.74 Typical High $831.76 | Professional | None (both parts) | $190.55 | $346.74 | $831.76 |
Priority Health Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $83.18 Typical High $144.54 | Professional | 26 · Professional part | $53.70 | $83.18 | $144.54 |
Priority Health Setting Professional Modifier TC · Technical part Typical Low $125.89 Median $204.17 Typical High $537.03 | Professional | TC · Technical part | $125.89 | $204.17 | $537.03 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $501.19 Typical High $1,023.29 | Facility | None | $218.78 | $501.19 | $1,023.29 |
Providence Setting Professional Modifier None (both parts) Typical Low $134.90 Median $302.00 Typical High $676.08 | Professional | None (both parts) | $134.90 | $302.00 | $676.08 |
Providence Setting Professional Modifier 26 · Professional part Typical Low $40.74 Median $69.18 Typical High $144.54 | Professional | 26 · Professional part | $40.74 | $69.18 | $144.54 |
Providence Setting Professional Modifier TC · Technical part Typical Low $81.28 Median $173.78 Typical High $562.34 | Professional | TC · Technical part | $81.28 | $173.78 | $562.34 |
Qualchoice Setting Professional Modifier None (both parts) Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | None (both parts) | $288.40 | $338.84 | $338.84 |
Qualchoice Setting Professional Modifier 26 · Professional part Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | 26 · Professional part | $128.82 | $128.82 | $144.54 |
Qualchoice Setting Professional Modifier TC · Technical part Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | TC · Technical part | $208.93 | $208.93 | $218.78 |
Quartz Setting Professional Modifier None Typical Low $213.80 Median $436.52 Typical High $1,000.00 | Professional | None | $213.80 | $436.52 | $1,000.00 |
Quartz Setting Professional Modifier None (both parts) Typical Low $281.84 Median $281.84 Typical High $954.99 | Professional | None (both parts) | $281.84 | $281.84 | $954.99 |
Quartz Setting Professional Modifier 26 · Professional part Typical Low $102.33 Median $102.33 Typical High $245.47 | Professional | 26 · Professional part | $102.33 | $102.33 | $245.47 |
Quartz Setting Professional Modifier TC · Technical part Typical Low $177.83 Median $177.83 Typical High $489.78 | Professional | TC · Technical part | $177.83 | $177.83 | $489.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $446.68 Median $724.44 Typical High $1,047.13 | Facility | None | $446.68 | $724.44 | $1,047.13 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $275.42 Median $380.19 Typical High $537.03 | Professional | None (both parts) | $275.42 | $380.19 | $537.03 |
Regence BlueShield Setting Professional Modifier 26 · Professional part Typical Low $97.72 Median $134.90 Typical High $186.21 | Professional | 26 · Professional part | $97.72 | $134.90 | $186.21 |
Regence BlueShield Setting Professional Modifier TC · Technical part Typical Low $181.97 Median $251.19 Typical High $346.74 | Professional | TC · Technical part | $181.97 | $251.19 | $346.74 |
Sanford Health Plan Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $630.96 | Professional | None | $257.04 | $354.81 | $630.96 |
Sanford Health Plan Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $114.82 Typical High $134.90 | Professional | 26 · Professional part | $87.10 | $114.82 | $134.90 |
Sanford Health Plan Setting Professional Modifier TC · Technical part Typical Low $173.78 Median $229.09 Typical High $537.03 | Professional | TC · Technical part | $173.78 | $229.09 | $537.03 |
Security Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Security Health Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,737.80 Typical High $2,691.53 | Professional | None (both parts) | $1,318.26 | $1,737.80 | $2,691.53 |
Security Health Setting Professional Modifier 26 · Professional part Typical Low $302.00 Median $446.68 Typical High $912.01 | Professional | 26 · Professional part | $302.00 | $446.68 | $912.01 |
Security Health Setting Professional Modifier TC · Technical part Typical Low $831.76 Median $1,584.89 Typical High $1,737.80 | Professional | TC · Technical part | $831.76 | $1,584.89 | $1,737.80 |
Select Health Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $1,479.11 | Facility | None | $177.83 | $199.53 | $1,479.11 |
Select Health Setting Professional Modifier None (both parts) Typical Low $177.83 Median $257.04 Typical High $478.63 | Professional | None (both parts) | $177.83 | $257.04 | $478.63 |
Select Health Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $95.50 Typical High $177.83 | Professional | 26 · Professional part | $66.07 | $95.50 | $177.83 |
Select Health Setting Professional Modifier TC · Technical part Typical Low $112.20 Median $154.88 Typical High $302.00 | Professional | TC · Technical part | $112.20 | $154.88 | $302.00 |
Sentara Setting Facility Modifier None Typical Low $83.18 Median $269.15 Typical High $1,584.89 | Facility | None | $83.18 | $269.15 | $1,584.89 |
Sentara Setting Professional Modifier None (both parts) Typical Low $93.33 Median $371.54 Typical High $724.44 | Professional | None (both parts) | $93.33 | $371.54 | $724.44 |
Sentara Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $95.50 Typical High $144.54 | Professional | 26 · Professional part | $74.13 | $95.50 | $144.54 |
Sentara Setting Professional Modifier TC · Technical part Typical Low $141.25 Median $309.03 Typical High $575.44 | Professional | TC · Technical part | $141.25 | $309.03 | $575.44 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $125.89 Median $158.49 Typical High $295.12 | Professional | None (both parts) | $125.89 | $158.49 | $295.12 |
SummaCare Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $77.62 Typical High $117.49 | Professional | 26 · Professional part | $66.07 | $77.62 | $117.49 |
SummaCare Setting Professional Modifier TC · Technical part Typical Low $58.88 Median $74.13 Typical High $186.21 | Professional | TC · Technical part | $58.88 | $74.13 | $186.21 |
Sutter Health Plus Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Sutter Health Plus Setting Professional Modifier None (both parts) Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None (both parts) | $724.44 | $724.44 | $724.44 |
Sutter Health Plus Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 26 · Professional part | $239.88 | $239.88 | $239.88 |
Sutter Health Plus Setting Professional Modifier TC · Technical part Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | TC · Technical part | $478.63 | $478.63 | $478.63 |
The Alliance Setting Professional Modifier None (both parts) Typical Low $338.84 Median $630.96 Typical High $1,348.96 | Professional | None (both parts) | $338.84 | $630.96 | $1,348.96 |
The Alliance Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $363.08 Typical High $537.03 | Professional | 26 · Professional part | $125.89 | $363.08 | $537.03 |
The Alliance Setting Professional Modifier TC · Technical part Typical Low $218.78 Median $489.78 Typical High $1,905.46 | Professional | TC · Technical part | $218.78 | $489.78 | $1,905.46 |
Tufts Setting Facility Modifier None Typical Low $257.04 Median $380.19 Typical High $724.44 | Facility | None | $257.04 | $380.19 | $724.44 |
Tufts Setting Professional Modifier None (both parts) Typical Low $173.78 Median $354.81 Typical High $426.58 | Professional | None (both parts) | $173.78 | $354.81 | $426.58 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $436.52 | Professional | None | $93.33 | $194.98 | $436.52 |
UPMC Health Plan Setting Facility Modifier None Typical Low $190.55 Median $724.44 Typical High $2,089.30 | Facility | None | $190.55 | $724.44 | $2,089.30 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $190.55 Median $549.54 Typical High $549.54 | Professional | None (both parts) | $190.55 | $549.54 | $549.54 |
UPMC Health Plan Setting Professional Modifier 26 · Professional part Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 26 · Professional part | $69.18 | $81.28 | $81.28 |
UPMC Health Plan Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $467.74 Typical High $467.74 | Professional | TC · Technical part | $123.03 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $389.05 Median $398.11 Typical High $851.14 | Facility | None | $389.05 | $398.11 | $851.14 |
United Setting Professional Modifier None (both parts) Typical Low $177.83 Median $275.42 Typical High $660.69 | Professional | None (both parts) | $177.83 | $275.42 | $660.69 |
United Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $75.86 Typical High $162.18 | Professional | 26 · Professional part | $57.54 | $75.86 | $162.18 |
United Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $177.83 Typical High $489.78 | Professional | TC · Technical part | $117.49 | $177.83 | $489.78 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $501.19 Typical High $645.65 | Facility | None | $213.80 | $501.19 | $645.65 |
Univera Setting Facility Modifier TC · Technical part Typical Low $134.90 Median $302.00 Typical High $416.87 | Facility | TC · Technical part | $134.90 | $302.00 | $416.87 |
Univera Setting Professional Modifier None (both parts) Typical Low $181.97 Median $239.88 Typical High $331.13 | Professional | None (both parts) | $181.97 | $239.88 | $331.13 |
Univera Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $66.07 Typical High $114.82 | Professional | 26 · Professional part | $33.11 | $66.07 | $114.82 |
Univera Setting Professional Modifier TC · Technical part Typical Low $114.82 Median $151.36 Typical High $275.42 | Professional | TC · Technical part | $114.82 | $151.36 | $275.42 |
University Health Alliance Setting Professional Modifier None (both parts) Typical Low $208.93 Median $389.05 Typical High $851.14 | Professional | None (both parts) | $208.93 | $389.05 | $851.14 |
University Health Alliance Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $125.89 Typical High $138.04 | Professional | 26 · Professional part | $66.07 | $125.89 | $138.04 |
University Health Alliance Setting Professional Modifier TC · Technical part Typical Low $141.25 Median $269.15 Typical High $707.95 | Professional | TC · Technical part | $141.25 | $269.15 | $707.95 |
Well Sense Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $512.86 | Facility | None | $257.04 | $363.08 | $512.86 |
Well Sense Setting Facility Modifier 26 · Professional part Typical Low $52.48 Median $67.61 Typical High $123.03 | Facility | 26 · Professional part | $52.48 | $67.61 | $123.03 |
Well Sense Setting Facility Modifier TC · Technical part Typical Low $204.17 Median $257.04 Typical High $426.58 | Facility | TC · Technical part | $204.17 | $257.04 | $426.58 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None (both parts) | $380.19 | $380.19 | $457.09 |
Wellmark Setting Professional Modifier None (both parts) Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | None (both parts) | $446.68 | $512.86 | $512.86 |
Wellmark Setting Professional Modifier 26 · Professional part Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 26 · Professional part | $158.49 | $181.97 | $181.97 |
Wellmark Setting Professional Modifier TC · Technical part Typical Low $288.40 Median $323.59 Typical High $331.13 | Professional | TC · Technical part | $288.40 | $323.59 | $331.13 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $147.91 Median $190.55 Typical High $199.53 | Professional | None (both parts) | $147.91 | $190.55 | $199.53 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $53.70 Median $69.18 Typical High $70.79 | Professional | 26 · Professional part | $53.70 | $69.18 | $70.79 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $123.03 Typical High $128.82 | Professional | TC · Technical part | $95.50 | $123.03 | $128.82 |
51 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 $97.72 Median $204.17 Typical High $724.44 | Facility | 52 · Reduced service | $97.72 | $204.17 | $724.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $38.90 Median $81.28 Typical High $295.12 | Facility | 53 · Discontinued | $38.90 | $81.28 | $295.12 |
Aetna Setting Facility Modifier FX · Film X-ray Typical Low $158.49 Median $380.19 Typical High $1,174.90 | Facility | FX · Film X-ray | $158.49 | $380.19 | $1,174.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $186.21 Typical High $263.03 | Professional | 52 · Reduced service | $100.00 | $186.21 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $74.13 Typical High $104.71 | Professional | 53 · Discontinued | $39.81 | $74.13 | $104.71 |
Aetna Setting Professional Modifier FX · Film X-ray Typical Low $158.49 Median $295.12 Typical High $380.19 | Professional | FX · Film X-ray | $158.49 | $295.12 | $380.19 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 59 · Distinct service | $147.91 | $151.36 | $186.21 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $218.78 Median $218.78 Typical High $269.15 | Professional | GC · Resident with teaching physician | $218.78 | $218.78 | $269.15 |
Ambetter Setting Professional Modifier Q5 · Substitute physician, reciprocal Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | Q5 · Substitute physician, reciprocal | $131.83 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | Q6 · Substitute physician, paid per time | $120.23 | $151.36 | $151.36 |
BCBS Alabama Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $95.50 Median $162.18 Typical High $263.03 | Professional | 81 · Minimal assistant surgeon | $95.50 | $162.18 | $263.03 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $218.78 | $257.04 | $346.74 |
BCBS Massachusetts Setting Facility Modifier 52 · Reduced service Typical Low $181.97 Median $316.23 Typical High $501.19 | Facility | 52 · Reduced service | $181.97 | $316.23 | $501.19 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $186.21 Typical High $537.03 | Professional | 52 · Reduced service | $38.02 | $186.21 | $537.03 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $93.33 Typical High $269.15 | Professional | 53 · Discontinued | $19.05 | $93.33 | $269.15 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $407.38 Median $524.81 Typical High $616.60 | Professional | 22 · Increased work | $407.38 | $524.81 | $616.60 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $102.33 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $537.03 Typical High $1,023.29 | Professional | 53 · Discontinued | $346.74 | $537.03 | $1,023.29 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $154.88 Typical High $295.12 | Professional | 55 · Aftercare only | $100.00 | $154.88 | $295.12 |
DeanCare Setting Facility Modifier 80 · Assistant surgeon Typical Low $177.83 Median $223.87 Typical High $281.84 | Facility | 80 · Assistant surgeon | $177.83 | $223.87 | $281.84 |
DeanCare Setting Facility Modifier 81 · Minimal assistant surgeon Typical Low $177.83 Median $223.87 Typical High $281.84 | Facility | 81 · Minimal assistant surgeon | $177.83 | $223.87 | $281.84 |
DeanCare Setting Facility Modifier 82 · Assistant surgeon, no resident Typical Low $177.83 Median $223.87 Typical High $281.84 | Facility | 82 · Assistant surgeon, no resident | $177.83 | $223.87 | $281.84 |
DeanCare Setting Facility Modifier AS · PA/NP assist Typical Low $154.88 Median $194.98 Typical High $245.47 | Facility | AS · PA/NP assist | $154.88 | $194.98 | $245.47 |
DeanCare Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $77.62 Typical High $87.10 | Professional | 80 · Assistant surgeon | $57.54 | $77.62 | $87.10 |
DeanCare Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $57.54 Median $77.62 Typical High $87.10 | Professional | 81 · Minimal assistant surgeon | $57.54 | $77.62 | $87.10 |
DeanCare Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $57.54 Median $77.62 Typical High $87.10 | Professional | 82 · Assistant surgeon, no resident | $57.54 | $77.62 | $87.10 |
DeanCare Setting Professional Modifier AS · PA/NP assist Typical Low $50.12 Median $67.61 Typical High $75.86 | Professional | AS · PA/NP assist | $50.12 | $67.61 | $75.86 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $213.80 Median $371.54 Typical High $691.83 | Professional | GL · Free upgrade | $213.80 | $371.54 | $691.83 |
Excellus BCBS Setting Professional Modifier FY · Cassette-based X-ray Typical Low $147.91 Median $204.17 Typical High $316.23 | Professional | FY · Cassette-based X-ray | $147.91 | $204.17 | $316.23 |
Health Alliance Plan Setting Facility Modifier ME · Imaging: follows guidelines Typical Low $478.63 Median $1,288.25 Typical High $1,698.24 | Facility | ME · Imaging: follows guidelines | $478.63 | $1,288.25 | $1,698.24 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $123.03 | $123.03 | $123.03 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Highmark BCBS Setting Facility Modifier PN · Off-campus dept, non-excepted Typical Low $89.13 Median $239.88 Typical High $1,778.28 | Facility | PN · Off-campus dept, non-excepted | $89.13 | $239.88 | $1,778.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $524.81 Typical High $724.44 | Professional | 53 · Discontinued | $120.23 | $524.81 | $724.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $100.00 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $39.81 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier FX · Film X-ray Typical Low $158.49 Median $338.84 Typical High $338.84 | Professional | FX · Film X-ray | $158.49 | $338.84 | $338.84 |
Medcost Setting Professional Modifier 27 · Multiple hospital visits Typical Low $588.84 Median $741.31 Typical High $741.31 | Professional | 27 · Multiple hospital visits | $588.84 | $741.31 | $741.31 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $162.18 Median $295.12 Typical High $446.68 | Professional | 51 · Multiple procedures | $162.18 | $295.12 | $446.68 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $123.03 Typical High $177.83 | Professional | 80 · Assistant surgeon | $64.57 | $123.03 | $177.83 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $45.71 Median $87.10 Typical High $125.89 | Professional | 81 · Minimal assistant surgeon | $45.71 | $87.10 | $125.89 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $45.71 Median $87.10 Typical High $125.89 | Professional | 82 · Assistant surgeon, no resident | $45.71 | $87.10 | $125.89 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $87.10 Typical High $125.89 | Professional | AS · PA/NP assist | $45.71 | $87.10 | $125.89 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $85.11 Median $199.53 Typical High $977.24 | Facility | 52 · Reduced service | $85.11 | $199.53 | $977.24 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $33.11 Median $61.66 Typical High $169.82 | Facility | 53 · Discontinued | $33.11 | $61.66 | $169.82 |
Moda Health Setting Facility Modifier FX · Film X-ray Typical Low $123.03 Median $204.17 Typical High $1,995.26 | Facility | FX · Film X-ray | $123.03 | $204.17 | $1,995.26 |
Moda Health Setting Facility Modifier ME · Imaging: follows guidelines Typical Low $389.05 Median $933.25 Typical High $1,905.46 | Facility | ME · Imaging: follows guidelines | $389.05 | $933.25 | $1,905.46 |
Moda Health Setting Facility Modifier MH · Imaging: guideline use unknown Typical Low $263.03 Median $1,548.82 Typical High $1,905.46 | Facility | MH · Imaging: guideline use unknown | $263.03 | $1,548.82 | $1,905.46 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $131.83 Typical High $302.00 | Professional | 52 · Reduced service | $83.18 | $131.83 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $52.48 Typical High $120.23 | Professional | 53 · Discontinued | $33.11 | $52.48 | $120.23 |
Univera Setting Professional Modifier FY · Cassette-based X-ray Typical Low $147.91 Median $204.17 Typical High $331.13 | Professional | FY · Cassette-based X-ray | $147.91 | $204.17 | $331.13 |
What it costs in each state
The same service costs 24.0 times more in Vermont than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Touch or drag across the chart to see any state's rate.
VT $2,951UT $123
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.