How much rates vary
Facilitymedian $20 · 10th to 90th $12 to $62Professionalmedian $11 · 10th to 90th $6 to $28
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 $10.47 Median $16.22 Typical High $61.66 | Facility | None | $10.47 | $16.22 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $20.89 | Professional | None | $10.00 | $12.02 | $20.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $10.00 Median $14.79 Typical High $42.66 | Facility | None | $10.00 | $14.79 | $42.66 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.37 Median $13.49 Typical High $33.88 | Professional | None | $5.37 | $13.49 | $33.88 |
Ambetter Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.59 Median $20.89 Typical High $56.23 | Facility | None | $12.59 | $20.89 | $56.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.61 Median $9.12 Typical High $28.18 | Professional | None | $6.61 | $9.12 | $28.18 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $10.00 Median $15.49 Typical High $37.15 | Facility | None | $10.00 | $15.49 | $37.15 |
Asuris Northwest Health Setting Professional Modifier None Typical Low $10.00 Median $12.02 Typical High $13.49 | Professional | None | $10.00 | $12.02 | $13.49 |
AvMed Setting Facility Modifier None Typical Low $10.72 Median $13.49 Typical High $16.22 | Facility | None | $10.72 | $13.49 | $16.22 |
AvMed Setting Professional Modifier None Typical Low $10.72 Median $13.49 Typical High $18.62 | Professional | None | $10.72 | $13.49 | $18.62 |
BCBS Alabama Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
BCBS Arizona Setting Facility Modifier None Typical Low $7.59 Median $33.88 Typical High $51.29 | Facility | None | $7.59 | $33.88 | $51.29 |
BCBS Arizona Setting Professional Modifier None Typical Low $7.08 Median $11.22 Typical High $16.22 | Professional | None | $7.08 | $11.22 | $16.22 |
BCBS Arkansas Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $20.89 | Facility | None | $15.14 | $15.14 | $20.89 |
BCBS Arkansas Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $22.39 | Professional | None | $15.14 | $22.39 | $22.39 |
BCBS Idaho Setting Facility Modifier None Typical Low $16.60 Median $38.02 Typical High $74.13 | Facility | None | $16.60 | $38.02 | $74.13 |
BCBS Idaho Setting Professional Modifier None Typical Low $11.48 Median $17.78 Typical High $19.95 | Professional | None | $11.48 | $17.78 | $19.95 |
BCBS Illinois Setting Facility Modifier None Typical Low $16.98 Median $29.51 Typical High $138.04 | Facility | None | $16.98 | $29.51 | $138.04 |
BCBS Illinois Setting Professional Modifier None Typical Low $3.47 Median $10.23 Typical High $10.23 | Professional | None | $3.47 | $10.23 | $10.23 |
BCBS Kansas Setting Facility Modifier None Typical Low $12.30 Median $12.88 Typical High $19.05 | Facility | None | $12.30 | $12.88 | $19.05 |
BCBS Kansas Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
BCBS Kansas City Setting Facility Modifier None Typical Low $12.59 Median $16.60 Typical High $31.62 | Facility | None | $12.59 | $16.60 | $31.62 |
BCBS Louisiana Setting Facility Modifier None Typical Low $16.60 Median $27.54 Typical High $50.12 | Facility | None | $16.60 | $27.54 | $50.12 |
BCBS Louisiana Setting Professional Modifier None Typical Low $11.22 Median $14.79 Typical High $19.95 | Professional | None | $11.22 | $14.79 | $19.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $18.62 Median $33.11 Typical High $56.23 | Facility | None | $18.62 | $33.11 | $56.23 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $12.59 Median $13.18 Typical High $16.98 | Professional | None | $12.59 | $13.18 | $16.98 |
BCBS Michigan Setting Facility Modifier None Typical Low $10.00 Median $14.13 Typical High $25.12 | Facility | None | $10.00 | $14.13 | $25.12 |
BCBS Michigan Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
BCBS Minnesota Setting Facility Modifier None Typical Low $12.59 Median $13.49 Typical High $125.89 | Facility | None | $12.59 | $13.49 | $125.89 |
BCBS Minnesota Setting Professional Modifier None Typical Low $10.72 Median $12.02 Typical High $13.49 | Professional | None | $10.72 | $12.02 | $13.49 |
BCBS Mississippi Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
BCBS Mississippi Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
BCBS Montana Setting Facility Modifier None Typical Low $17.78 Median $46.77 Typical High $102.33 | Facility | None | $17.78 | $46.77 | $102.33 |
BCBS Montana Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
BCBS Nebraska Setting Facility Modifier None Typical Low $30.90 Median $40.74 Typical High $85.11 | Facility | None | $30.90 | $40.74 | $85.11 |
BCBS North Carolina Setting Facility Modifier None Typical Low $29.51 Median $57.54 Typical High $57.54 | Facility | None | $29.51 | $57.54 | $57.54 |
BCBS North Carolina Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $12.02 | Professional | None | $7.94 | $7.94 | $12.02 |
BCBS North Dakota Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $26.92 | Professional | None | $17.38 | $22.91 | $26.92 |
BCBS Oklahoma Setting Facility Modifier None Typical Low $33.11 Median $43.65 Typical High $56.23 | Facility | None | $33.11 | $43.65 | $56.23 |
BCBS Oklahoma Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $13.49 | Professional | None | $12.59 | $12.59 | $13.49 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $15.49 Median $16.22 Typical High $26.92 | Facility | None | $15.49 | $16.22 | $26.92 |
BCBS Rhode Island Setting Professional Modifier None Typical Low $7.59 Median $10.00 Typical High $26.92 | Professional | None | $7.59 | $10.00 | $26.92 |
BCBS South Carolina Setting Facility Modifier None Typical Low $34.67 Median $53.70 Typical High $93.33 | Facility | None | $34.67 | $53.70 | $93.33 |
BCBS South Carolina Setting Professional Modifier None Typical Low $13.49 Median $28.18 Typical High $33.88 | Professional | None | $13.49 | $28.18 | $33.88 |
BCBS Tennessee Setting Professional Modifier None Typical Low $6.92 Median $14.79 Typical High $18.20 | Professional | None | $6.92 | $14.79 | $18.20 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $7.41 Typical High $7.59 | Professional | None | $5.01 | $7.41 | $7.59 |
BCBS Vermont Setting Facility Modifier None Typical Low $104.71 Median $229.09 Typical High $239.88 | Facility | None | $104.71 | $229.09 | $239.88 |
BCBS Vermont Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
BCBS Wyoming Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $19.95 | Facility | None | $16.60 | $16.60 | $19.95 |
BCBS Wyoming Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $42.66 | Professional | None | $16.60 | $20.89 | $42.66 |
Blue Shield Setting Facility Modifier None Typical Low $34.67 Median $107.15 Typical High $204.17 | Facility | None | $34.67 | $107.15 | $204.17 |
Blue Shield Setting Professional Modifier None Typical Low $8.32 Median $11.75 Typical High $21.38 | Professional | None | $8.32 | $11.75 | $21.38 |
CDPHP Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | None | $13.49 | $13.49 | $13.49 |
Capital Blue Cross Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $5,011.87 | Facility | None | $75.86 | $100.00 | $5,011.87 |
Capital Blue Cross Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | None | $10.47 | $10.47 | $13.18 |
CareFirst Setting Professional Modifier None Typical Low $9.55 Median $10.72 Typical High $14.45 | Professional | None | $9.55 | $10.72 | $14.45 |
CareSource Setting Facility Modifier None Typical Low $10.72 Median $15.49 Typical High $18.62 | Facility | None | $10.72 | $15.49 | $18.62 |
CareSource Setting Professional Modifier None Typical Low $14.45 Median $16.60 Typical High $21.88 | Professional | None | $14.45 | $16.60 | $21.88 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $17.38 | Professional | None | $10.72 | $10.72 | $17.38 |
Christus Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $15.49 | Facility | None | $13.49 | $13.49 | $15.49 |
Cigna Setting Facility Modifier None Typical Low $10.72 Median $26.92 Typical High $54.95 | Facility | None | $10.72 | $26.92 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $15.14 Typical High $31.62 | Professional | None | $7.08 | $15.14 | $31.62 |
ConnectiCare Setting Professional Modifier None Typical Low $7.94 Median $10.72 Typical High $19.50 | Professional | None | $7.94 | $10.72 | $19.50 |
Contra Costa Health Setting Professional Modifier None Typical Low $12.02 Median $14.79 Typical High $14.79 | Professional | None | $12.02 | $14.79 | $14.79 |
DeanCare Setting Facility Modifier None Typical Low $12.02 Median $66.07 Typical High $102.33 | Facility | None | $12.02 | $66.07 | $102.33 |
Denver HMP Setting Facility Modifier None Typical Low $10.23 Median $14.45 Typical High $26.92 | Facility | None | $10.23 | $14.45 | $26.92 |
Emblem Health Setting Facility Modifier None Typical Low $7.08 Median $13.49 Typical High $30.20 | Facility | None | $7.08 | $13.49 | $30.20 |
Emblem Health Setting Professional Modifier None Typical Low $6.31 Median $7.94 Typical High $25.70 | Professional | None | $6.31 | $7.94 | $25.70 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $8.71 Median $13.49 Typical High $15.14 | Professional | None | $8.71 | $13.49 | $15.14 |
Fallon Health Setting Facility Modifier None Typical Low $15.49 Median $22.39 Typical High $4,897.79 | Facility | None | $15.49 | $22.39 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | None | $19.05 | $19.05 | $22.39 |
Florida Blue Setting Facility Modifier None Typical Low $13.80 Median $24.55 Typical High $89.13 | Facility | None | $13.80 | $24.55 | $89.13 |
Florida Blue Setting Professional Modifier None Typical Low $7.94 Median $10.47 Typical High $18.62 | Professional | None | $7.94 | $10.47 | $18.62 |
Geisinger Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Geisinger Setting Professional Modifier None Typical Low $11.48 Median $14.79 Typical High $23.99 | Professional | None | $11.48 | $14.79 | $23.99 |
HMSA Setting Professional Modifier None Typical Low $22.91 Median $23.99 Typical High $33.11 | Professional | None | $22.91 | $23.99 | $33.11 |
Hally Health Setting Professional Modifier None Typical Low $13.49 Median $23.44 Typical High $131.83 | Professional | None | $13.49 | $23.44 | $131.83 |
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 $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.61 Median $13.49 Typical High $48.98 | Professional | None | $6.61 | $13.49 | $48.98 |
Health Alliance Plan Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $47.86 | Facility | None | $12.59 | $12.59 | $47.86 |
Health Alliance Plan Setting Professional Modifier None Typical Low $12.30 Median $17.78 Typical High $23.44 | Professional | None | $12.30 | $17.78 | $23.44 |
Health New England Setting Facility Modifier None Typical Low $18.20 Median $34.67 Typical High $165.96 | Facility | None | $18.20 | $34.67 | $165.96 |
Health Partners Setting Facility Modifier None Typical Low $25.12 Median $41.69 Typical High $97.72 | Facility | None | $25.12 | $41.69 | $97.72 |
Health Partners Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $25.70 | Professional | None | $15.14 | $15.14 | $25.70 |
Health Smart Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Facility | None | $20.42 | $20.42 | $20.42 |
Health Smart Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $23.44 | Professional | None | $20.42 | $20.42 | $23.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $154.88 | Facility | None | $35.48 | $42.66 | $154.88 |
Highmark BCBS Setting Professional Modifier None Typical Low $7.94 Median $9.12 Typical High $10.00 | Professional | None | $7.94 | $9.12 | $10.00 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $13.49 Typical High $21.88 | Professional | None | $4.57 | $13.49 | $21.88 |
Hometown Health Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
Horizon BCBS Setting Facility Modifier None Typical Low $12.30 Median $97.72 Typical High $151.36 | Facility | None | $12.30 | $97.72 | $151.36 |
Horizon BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $35.48 | Professional | None | $12.02 | $16.22 | $35.48 |
Lucent Health Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
MVP Health Care Setting Facility Modifier None Typical Low $13.49 Median $19.95 Typical High $257.04 | Facility | None | $13.49 | $19.95 | $257.04 |
MVP Health Care Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $33.88 | Professional | None | $10.72 | $10.72 | $33.88 |
Martin's Point Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $38.90 | Facility | None | $10.96 | $10.96 | $38.90 |
Martin's Point Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | None | $10.96 | $10.96 | $12.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $10.00 Median $14.79 Typical High $42.66 | Facility | None | $10.00 | $14.79 | $42.66 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.37 Median $13.49 Typical High $33.88 | Professional | None | $5.37 | $13.49 | $33.88 |
Medcost Setting Professional Modifier None Typical Low $10.96 Median $28.84 Typical High $60.26 | Professional | None | $10.96 | $28.84 | $60.26 |
Medcost Setting Facility Modifier None Typical Low $10.47 Median $12.30 Typical High $27.54 | Facility | None | $10.47 | $12.30 | $27.54 |
Medcost Setting Professional Modifier None Typical Low $15.14 Median $20.42 Typical High $33.88 | Professional | None | $15.14 | $20.42 | $33.88 |
Medica Setting Facility Modifier None Typical Low $10.72 Median $17.38 Typical High $85.11 | Facility | None | $10.72 | $17.38 | $85.11 |
Medica Setting Professional Modifier None Typical Low $5.62 Median $9.33 Typical High $30.20 | Professional | None | $5.62 | $9.33 | $30.20 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $8.71 Median $15.49 Typical High $54.95 | Facility | None | $8.71 | $15.49 | $54.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $6.76 Median $8.51 Typical High $18.62 | Professional | None | $6.76 | $8.51 | $18.62 |
Midlands Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $24.55 | Professional | None | $16.22 | $16.22 | $24.55 |
Midlands Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Moda Health Setting Facility Modifier None Typical Low $10.23 Median $13.80 Typical High $44.67 | Facility | None | $10.23 | $13.80 | $44.67 |
Moda Health Setting Professional Modifier None Typical Low $7.94 Median $12.88 Typical High $26.30 | Professional | None | $7.94 | $12.88 | $26.30 |
Molina Setting Professional Modifier None Typical Low $7.08 Median $10.00 Typical High $14.13 | Professional | None | $7.08 | $10.00 | $14.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $13.49 Median $22.91 Typical High $28.84 | Facility | None | $13.49 | $22.91 | $28.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $14.13 Median $19.95 Typical High $25.12 | Professional | None | $14.13 | $19.95 | $25.12 |
Network Health Setting Facility Modifier None Typical Low $16.22 Median $20.42 Typical High $38.02 | Facility | None | $16.22 | $20.42 | $38.02 |
Network Health Setting Professional Modifier None Typical Low $10.00 Median $13.80 Typical High $38.02 | Professional | None | $10.00 | $13.80 | $38.02 |
Pacific Source Setting Facility Modifier None Typical Low $13.49 Median $15.14 Typical High $26.92 | Facility | None | $13.49 | $15.14 | $26.92 |
Pacific Source Setting Professional Modifier None Typical Low $13.49 Median $14.79 Typical High $26.92 | Professional | None | $13.49 | $14.79 | $26.92 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $23.99 Median $33.11 Typical High $2,187.76 | Facility | None | $23.99 | $33.11 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $8.71 Median $10.72 Typical High $12.02 | Professional | None | $8.71 | $10.72 | $12.02 |
Premera BCBS Setting Facility Modifier None Typical Low $14.79 Median $24.55 Typical High $46.77 | Facility | None | $14.79 | $24.55 | $46.77 |
Premera BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $30.20 | Professional | None | $12.02 | $12.02 | $30.20 |
Prevea360 Setting Facility Modifier None Typical Low $10.72 Median $12.02 Typical High $16.98 | Facility | None | $10.72 | $12.02 | $16.98 |
Priority Health Setting Professional Modifier None Typical Low $8.51 Median $13.49 Typical High $17.38 | Professional | None | $8.51 | $13.49 | $17.38 |
Providence Setting Facility Modifier None Typical Low $10.96 Median $19.05 Typical High $53.70 | Facility | None | $10.96 | $19.05 | $53.70 |
Providence Setting Professional Modifier None Typical Low $8.51 Median $14.79 Typical High $30.20 | Professional | None | $8.51 | $14.79 | $30.20 |
Quartz Setting Professional Modifier None Typical Low $14.79 Median $31.62 Typical High $54.95 | Professional | None | $14.79 | $31.62 | $54.95 |
Quartz Setting Professional Modifier None Typical Low $6.31 Median $8.91 Typical High $34.67 | Professional | None | $6.31 | $8.91 | $34.67 |
Regence BlueShield Setting Facility Modifier None Typical Low $15.49 Median $30.90 Typical High $57.54 | Facility | None | $15.49 | $30.90 | $57.54 |
Regence BlueShield Setting Professional Modifier None Typical Low $10.00 Median $11.48 Typical High $14.79 | Professional | None | $10.00 | $11.48 | $14.79 |
Sanford Health Plan Setting Professional Modifier None Typical Low $21.88 Median $30.90 Typical High $37.15 | Professional | None | $21.88 | $30.90 | $37.15 |
Security Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $28.18 | Professional | None | $13.80 | $13.80 | $28.18 |
Security Health Setting Professional Modifier None Typical Low $13.80 Median $72.44 Typical High $93.33 | Professional | None | $13.80 | $72.44 | $93.33 |
Select Health Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $61.66 | Facility | None | $13.49 | $13.49 | $61.66 |
Select Health Setting Professional Modifier None Typical Low $9.33 Median $13.49 Typical High $17.38 | Professional | None | $9.33 | $13.49 | $17.38 |
Sentara Setting Facility Modifier None Typical Low $12.02 Median $19.05 Typical High $10,232.93 | Facility | None | $12.02 | $19.05 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $12.02 Median $18.62 Typical High $10,232.93 | Professional | None | $12.02 | $18.62 | $10,232.93 |
SummaCare Setting Professional Modifier None Typical Low $8.71 Median $11.48 Typical High $16.22 | Professional | None | $8.71 | $11.48 | $16.22 |
Sutter Health Plus Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $8.71 Median $13.49 Typical High $22.91 | Professional | None | $8.71 | $13.49 | $22.91 |
UPMC Health Plan Setting Facility Modifier None Typical Low $13.49 Median $57.54 Typical High $120.23 | Facility | None | $13.49 | $57.54 | $120.23 |
UPMC Health Plan Setting Professional Modifier None Typical Low $11.75 Median $13.49 Typical High $19.05 | Professional | None | $11.75 | $13.49 | $19.05 |
United Setting Facility Modifier None Typical Low $7.94 Median $13.49 Typical High $16.22 | Facility | None | $7.94 | $13.49 | $16.22 |
United Setting Professional Modifier None Typical Low $5.62 Median $7.94 Typical High $22.39 | Professional | None | $5.62 | $7.94 | $22.39 |
Univera Setting Facility Modifier None Typical Low $8.71 Median $13.49 Typical High $24.55 | Facility | None | $8.71 | $13.49 | $24.55 |
Univera Setting Professional Modifier None Typical Low $8.71 Median $13.49 Typical High $17.38 | Professional | None | $8.71 | $13.49 | $17.38 |
University Health Alliance Setting Professional Modifier None Typical Low $15.14 Median $25.12 Typical High $35.48 | Professional | None | $15.14 | $25.12 | $35.48 |
Well Sense Setting Facility Modifier None Typical Low $11.75 Median $14.79 Typical High $23.44 | Facility | None | $11.75 | $14.79 | $23.44 |
Well Sense Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | None | $13.80 | $13.80 | $16.60 |
Wellmark Setting Professional Modifier None Typical Low $10.47 Median $13.49 Typical High $13.49 | Professional | None | $10.47 | $13.49 | $13.49 |
Wellpoint Setting Professional Modifier None Typical Low $6.61 Median $6.92 Typical High $13.49 | Professional | None | $6.61 | $6.92 | $13.49 |
20 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 $5.13 Median $8.13 Typical High $32.36 | Facility | 52 · Reduced service | $5.13 | $8.13 | $32.36 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.04 Median $3.24 Typical High $12.88 | Facility | 53 · Discontinued | $2.04 | $3.24 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.90 Median $5.89 Typical High $11.22 | Professional | 52 · Reduced service | $4.90 | $5.89 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.40 Typical High $4.47 | Professional | 53 · Discontinued | $2.00 | $2.40 | $4.47 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers Typical Low $9.33 Median $11.22 Typical High $13.80 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 + 55 · Aftercare only + 99 · Multiple modifiers | $9.33 | $11.22 | $13.80 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $20.89 Median $27.54 Typical High $32.36 | Professional | 22 · Increased work | $20.89 | $27.54 | $32.36 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $4.57 Typical High $5.37 | Professional | 55 · Aftercare only | $3.47 | $4.57 | $5.37 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.79 Typical High $30.20 | Professional | 53 · Discontinued | $11.75 | $14.79 | $30.20 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.17 Typical High $8.51 | Professional | 55 · Aftercare only | $3.39 | $4.17 | $8.51 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $13.49 Median $17.38 Typical High $20.89 | Facility | QW · Waived lab test | $13.49 | $17.38 | $20.89 |
Health Alliance Plan Setting Facility Modifier 52 · Reduced service Typical Low $6.31 Median $6.31 Typical High $10.00 | Facility | 52 · Reduced service | $6.31 | $6.31 | $10.00 |
Health Alliance Plan Setting Facility Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $3.98 | Facility | 53 · Discontinued | $2.51 | $2.51 | $3.98 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $6.31 | $6.31 | $6.31 |
Health Alliance Plan Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5.37 Median $5.37 Typical High $5.75 | Professional | 52 · Reduced service | $5.37 | $5.37 | $5.75 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $2.29 | Professional | 53 · Discontinued | $2.19 | $2.19 | $2.29 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $5.01 Median $12.02 Typical High $36.31 | Facility | 52 · Reduced service | $5.01 | $12.02 | $36.31 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $2.04 Median $4.79 Typical High $14.45 | Facility | 53 · Discontinued | $2.04 | $4.79 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $4.79 Typical High $13.18 | Professional | 52 · Reduced service | $3.98 | $4.79 | $13.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.95 Typical High $5.25 | Professional | 53 · Discontinued | $1.62 | $1.95 | $5.25 |
What it costs in each state
The same service costs 3.7 times more in Alaska than in Texas. 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.
AK $30.20TX $8.13
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.