How much rates vary
Facilitymedian $162 · 10th to 90th $100 to $490Professionalmedian $158 · 10th to 90th $112 to $288
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 $102.33 Median $144.54 Typical High $204.17 | Facility | None | $102.33 | $144.54 | $204.17 |
Aetna Setting Professional Modifier None (both parts) Typical Low $109.65 Median $151.36 Typical High $213.80 | Professional | None (both parts) | $109.65 | $151.36 | $213.80 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $371.54 | Facility | None | $91.20 | $141.25 | $371.54 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $154.88 Median $316.23 Typical High $1,122.02 | Professional | None (both parts) | $154.88 | $316.23 | $1,122.02 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $114.82 Median $158.49 Typical High $218.78 | Professional | None (both parts) | $114.82 | $158.49 | $218.78 |
AmeriHealth Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None (both parts) | $239.88 | $239.88 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $144.54 Typical High $537.03 | Facility | None | $114.82 | $144.54 | $537.03 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $104.71 Median $125.89 Typical High $208.93 | Professional | None (both parts) | $104.71 | $125.89 | $208.93 |
Asuris Northwest Health Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $380.19 | Facility | None | $100.00 | $245.47 | $380.19 |
Asuris Northwest Health Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,122.02 |
Aultcare Setting Professional Modifier None (both parts) Typical Low $151.36 Median $169.82 Typical High $204.17 | Professional | None (both parts) | $151.36 | $169.82 | $204.17 |
AvMed Setting Professional Modifier None (both parts) Typical Low $144.54 Median $169.82 Typical High $194.98 | Professional | None (both parts) | $144.54 | $169.82 | $194.98 |
BCBS Arizona Setting Facility Modifier None Typical Low $162.18 Median $645.65 Typical High $1,096.48 | Facility | None | $162.18 | $645.65 | $1,096.48 |
BCBS Arizona Setting Professional Modifier None (both parts) Typical Low $112.20 Median $141.25 Typical High $169.82 | Professional | None (both parts) | $112.20 | $141.25 | $169.82 |
BCBS Idaho Setting Facility Modifier None Typical Low $199.53 Median $281.84 Typical High $380.19 | Facility | None | $199.53 | $281.84 | $380.19 |
BCBS Idaho Setting Professional Modifier None (both parts) Typical Low $223.87 Median $269.15 Typical High $316.23 | Professional | None (both parts) | $223.87 | $269.15 | $316.23 |
BCBS Illinois Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $1,862.09 | Facility | None | $371.54 | $602.56 | $1,862.09 |
BCBS Kansas Setting Facility Modifier None Typical Low $154.88 Median $162.18 Typical High $162.18 | Facility | None | $154.88 | $162.18 | $162.18 |
BCBS Kansas Setting Professional Modifier None (both parts) Typical Low $138.04 Median $162.18 Typical High $194.98 | Professional | None (both parts) | $138.04 | $162.18 | $194.98 |
BCBS Kansas City Setting Professional Modifier None (both parts) Typical Low $134.90 Median $158.49 Typical High $194.98 | Professional | None (both parts) | $134.90 | $158.49 | $194.98 |
BCBS Louisiana Setting Facility Modifier None Typical Low $27.54 Median $50.12 Typical High $331.13 | Facility | None | $27.54 | $50.12 | $331.13 |
BCBS Louisiana Setting Professional Modifier None (both parts) Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | None (both parts) | $114.82 | $134.90 | $162.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Facility | None | $389.05 | $389.05 | $457.09 |
BCBS Michigan Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
BCBS Michigan Setting Professional Modifier None (both parts) Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | None (both parts) | $194.98 | $204.17 | $204.17 |
BCBS Minnesota Setting Facility Modifier None Typical Low $234.42 Median $489.78 Typical High $1,513.56 | Facility | None | $234.42 | $489.78 | $1,513.56 |
BCBS Minnesota Setting Professional Modifier None (both parts) Typical Low $186.21 Median $257.04 Typical High $407.38 | Professional | None (both parts) | $186.21 | $257.04 | $407.38 |
BCBS Mississippi Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
BCBS Mississippi Setting Professional Modifier None (both parts) Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | None (both parts) | $151.36 | $169.82 | $169.82 |
BCBS Nebraska Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $426.58 | Facility | None | $363.08 | $363.08 | $426.58 |
BCBS Nebraska Setting Professional Modifier None (both parts) Typical Low $109.65 Median $186.21 Typical High $251.19 | Professional | None (both parts) | $109.65 | $186.21 | $251.19 |
BCBS North Carolina Setting Professional Modifier None (both parts) Typical Low $199.53 Median $295.12 Typical High $416.87 | Professional | None (both parts) | $199.53 | $295.12 | $416.87 |
BCBS Oklahoma Setting Professional Modifier None (both parts) Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None (both parts) | $173.78 | $173.78 | $173.78 |
BCBS Rhode Island Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $436.52 | Facility | None | $251.19 | $331.13 | $436.52 |
BCBS Rhode Island Setting Professional Modifier None (both parts) Typical Low $128.82 Median $151.36 Typical High $181.97 | Professional | None (both parts) | $128.82 | $151.36 | $181.97 |
BCBS South Carolina Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $229.09 | Facility | None | $131.83 | $223.87 | $229.09 |
BCBS South Carolina Setting Professional Modifier None (both parts) Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | None (both parts) | $147.91 | $173.78 | $173.78 |
BCBS Tennessee Setting Professional Modifier None (both parts) Typical Low $123.03 Median $147.91 Typical High $234.42 | Professional | None (both parts) | $123.03 | $147.91 | $234.42 |
BCBS Texas Setting Facility Modifier None Typical Low $204.17 Median $467.74 Typical High $831.76 | Facility | None | $204.17 | $467.74 | $831.76 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $173.78 Median $257.04 Typical High $380.19 | Professional | None (both parts) | $173.78 | $257.04 | $380.19 |
BCBS Vermont Setting Professional Modifier None (both parts) Typical Low $245.47 Median $309.03 Typical High $309.03 | Professional | None (both parts) | $245.47 | $309.03 | $309.03 |
BCBS Wyoming Setting Professional Modifier None (both parts) Typical Low $194.98 Median $239.88 Typical High $288.40 | Professional | None (both parts) | $194.98 | $239.88 | $288.40 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $147.91 Median $154.88 Typical High $181.97 | Professional | None (both parts) | $147.91 | $154.88 | $181.97 |
Blue Shield Setting Facility Modifier None Typical Low $64.57 Median $83.18 Typical High $89.13 | Facility | None | $64.57 | $83.18 | $89.13 |
Blue Shield Setting Professional Modifier None (both parts) Typical Low $64.57 Median $194.98 Typical High $512.86 | Professional | None (both parts) | $64.57 | $194.98 | $512.86 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | None (both parts) | $213.80 | $213.80 | $251.19 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None (both parts) Typical Low $302.00 Median $346.74 Typical High $407.38 | Professional | None (both parts) | $302.00 | $346.74 | $407.38 |
CareFirst Setting Professional Modifier None (both parts) Typical Low $83.18 Median $87.10 Typical High $117.49 | Professional | None (both parts) | $83.18 | $87.10 | $117.49 |
CareSource Setting Facility Modifier None Typical Low $104.71 Median $125.89 Typical High $173.78 | Facility | None | $104.71 | $125.89 | $173.78 |
CareSource Setting Professional Modifier None (both parts) Typical Low $147.91 Median $158.49 Typical High $208.93 | Professional | None (both parts) | $147.91 | $158.49 | $208.93 |
Central California Alliance for Health Setting Professional Modifier None (both parts) Typical Low $141.25 Median $173.78 Typical High $213.80 | Professional | None (both parts) | $141.25 | $173.78 | $213.80 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $186.21 Typical High $223.87 | Facility | None | $177.83 | $186.21 | $223.87 |
Cigna Setting Professional Modifier None (both parts) Typical Low $114.82 Median $162.18 Typical High $257.04 | Professional | None (both parts) | $114.82 | $162.18 | $257.04 |
Community Health Options Setting Professional Modifier None (both parts) Typical Low $194.98 Median $257.04 Typical High $323.59 | Professional | None (both parts) | $194.98 | $257.04 | $323.59 |
ConnectiCare Setting Professional Modifier None (both parts) Typical Low $141.25 Median $199.53 Typical High $245.47 | Professional | None (both parts) | $141.25 | $199.53 | $245.47 |
Contra Costa Health Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $109.65 | Professional | None | $64.57 | $81.28 | $109.65 |
DeanCare Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $331.13 | Facility | None | $138.04 | $165.96 | $331.13 |
DeanCare Setting Professional Modifier None (both parts) Typical Low $234.42 Median $288.40 Typical High $407.38 | Professional | None (both parts) | $234.42 | $288.40 | $407.38 |
Denver HMP Setting Facility Modifier None Typical Low $120.23 Median $190.55 Typical High $263.03 | Facility | None | $120.23 | $190.55 | $263.03 |
Denver HMP Setting Professional Modifier None (both parts) Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None (both parts) | $218.78 | $218.78 | $218.78 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $107.15 Typical High $338.84 | Facility | None | $0.10 | $107.15 | $338.84 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $75.86 Median $114.82 Typical High $263.03 | Professional | None (both parts) | $75.86 | $114.82 | $263.03 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $112.20 Median $112.20 Typical High $323.59 | Professional | None (both parts) | $112.20 | $112.20 | $323.59 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $151.36 Typical High $218.78 | Facility | None | $83.18 | $151.36 | $218.78 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $104.71 Median $181.97 Typical High $269.15 | Professional | None (both parts) | $104.71 | $181.97 | $269.15 |
Florida Blue Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Florida Blue Setting Professional Modifier None (both parts) Typical Low $87.10 Median $158.49 Typical High $194.98 | Professional | None (both parts) | $87.10 | $158.49 | $194.98 |
Geisinger Setting Professional Modifier None (both parts) Typical Low $169.82 Median $269.15 Typical High $501.19 | Professional | None (both parts) | $169.82 | $269.15 | $501.19 |
HMSA Setting Professional Modifier None (both parts) Typical Low $186.21 Median $218.78 Typical High $245.47 | Professional | None (both parts) | $186.21 | $218.78 | $245.47 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $478.63 | Professional | None | $138.04 | $190.55 | $478.63 |
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 $162.18 Median $165.96 Typical High $213.80 | Professional | None (both parts) | $162.18 | $165.96 | $213.80 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $158.49 Median $251.19 Typical High $446.68 | Professional | None (both parts) | $158.49 | $251.19 | $446.68 |
Health Alliance Plan Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $512.86 | Facility | None | $123.03 | $173.78 | $512.86 |
Health Alliance Plan Setting Professional Modifier None (both parts) Typical Low $125.89 Median $165.96 Typical High $204.17 | Professional | None (both parts) | $125.89 | $165.96 | $204.17 |
Health Partners Setting Professional Modifier None (both parts) Typical Low $151.36 Median $281.84 Typical High $389.05 | Professional | None (both parts) | $151.36 | $281.84 | $389.05 |
Health Smart Setting Professional Modifier None (both parts) Typical Low $181.97 Median $204.17 Typical High $724.44 | Professional | None (both parts) | $181.97 | $204.17 | $724.44 |
HealthNet Setting Professional Modifier None (both parts) Typical Low $524.81 Median $524.81 Typical High $691.83 | Professional | None (both parts) | $524.81 | $524.81 | $691.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $269.15 | Facility | None | $169.82 | $239.88 | $269.15 |
Hometown Health Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $186.21 | Professional | None | $1.41 | $1.41 | $186.21 |
Hometown Health Setting Professional Modifier None (both parts) Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | None (both parts) | $1.41 | $1.41 | $1.41 |
Horizon BCBS Setting Professional Modifier None (both parts) Typical Low $181.97 Median $181.97 Typical High $288.40 | Professional | None (both parts) | $181.97 | $181.97 | $288.40 |
Independence Blue Cross Setting Professional Modifier None (both parts) Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None (both parts) | $239.88 | $239.88 | $239.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $331.13 | Professional | None | $141.25 | $194.98 | $331.13 |
Kaiser Permanente Setting Professional Modifier None (both parts) Typical Low $134.90 Median $204.17 Typical High $338.84 | Professional | None (both parts) | $134.90 | $204.17 | $338.84 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None (both parts) | $128.82 | $128.82 | $128.82 |
Martin's Point Setting Facility Modifier None Typical Low $7.94 Median $14.79 Typical High $169.82 | Facility | None | $7.94 | $14.79 | $169.82 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $9.55 Median $151.36 Typical High $204.17 | Professional | None (both parts) | $9.55 | $151.36 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $371.54 | Facility | None | $91.20 | $141.25 | $371.54 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $154.88 Median $316.23 Typical High $1,122.02 | Professional | None (both parts) | $154.88 | $316.23 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $257.04 | Professional | None | $165.96 | $208.93 | $257.04 |
Medcost Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $263.03 | Facility | None | $147.91 | $194.98 | $263.03 |
Medcost Setting Professional Modifier None (both parts) Typical Low $128.82 Median $199.53 Typical High $223.87 | Professional | None (both parts) | $128.82 | $199.53 | $223.87 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $223.87 Typical High $602.56 | Facility | None | $147.91 | $223.87 | $602.56 |
Medica Setting Professional Modifier None (both parts) Typical Low $165.96 Median $933.25 Typical High $1,122.02 | Professional | None (both parts) | $165.96 | $933.25 | $1,122.02 |
Medical Mutual of Ohio Setting Professional Modifier None (both parts) Typical Low $141.25 Median $169.82 Typical High $275.42 | Professional | None (both parts) | $141.25 | $169.82 | $275.42 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $407.38 | Professional | None | $257.04 | $331.13 | $407.38 |
Midlands Setting Professional Modifier None (both parts) Typical Low $257.04 Median $309.03 Typical High $407.38 | Professional | None (both parts) | $257.04 | $309.03 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $257.04 | Facility | None | $100.00 | $158.49 | $257.04 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $100.00 Median $162.18 Typical High $229.09 | Professional | None (both parts) | $100.00 | $162.18 | $229.09 |
Molina Setting Professional Modifier None (both parts) Typical Low $83.18 Median $134.90 Typical High $194.98 | Professional | None (both parts) | $83.18 | $134.90 | $194.98 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $302.00 | Facility | None | $229.09 | $263.03 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None (both parts) Typical Low $229.09 Median $251.19 Typical High $295.12 | Professional | None (both parts) | $229.09 | $251.19 | $295.12 |
Network Health Setting Professional Modifier None (both parts) Typical Low $281.84 Median $331.13 Typical High $416.87 | Professional | None (both parts) | $281.84 | $331.13 | $416.87 |
Optum Setting Professional Modifier None (both parts) Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | None (both parts) | $154.88 | $169.82 | $204.17 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $131.83 Median $162.18 Typical High $204.17 | Professional | None (both parts) | $131.83 | $162.18 | $204.17 |
Pacific Source Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $346.74 | Facility | None | $208.93 | $316.23 | $346.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $363.08 Median $467.74 Typical High $2,187.76 | Facility | None | $363.08 | $467.74 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None (both parts) Typical Low $114.82 Median $158.49 Typical High $239.88 | Professional | None (both parts) | $114.82 | $158.49 | $239.88 |
Premera BCBS Setting Professional Modifier None (both parts) Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None (both parts) | $251.19 | $251.19 | $251.19 |
Prevea360 Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $331.13 | Facility | None | $138.04 | $165.96 | $331.13 |
Priority Health Setting Professional Modifier None (both parts) Typical Low $128.82 Median $169.82 Typical High $208.93 | Professional | None (both parts) | $128.82 | $169.82 | $208.93 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $288.40 | Facility | None | $134.90 | $177.83 | $288.40 |
Providence Setting Professional Modifier None (both parts) Typical Low $117.49 Median $165.96 Typical High $281.84 | Professional | None (both parts) | $117.49 | $165.96 | $281.84 |
Qualchoice 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 |
Quartz Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $478.63 | Professional | None | $177.83 | $323.59 | $478.63 |
Quartz Setting Professional Modifier None (both parts) Typical Low $147.91 Median $177.83 Typical High $218.78 | Professional | None (both parts) | $147.91 | $177.83 | $218.78 |
Regence BlueShield Setting Facility Modifier None Typical Low $223.87 Median $323.59 Typical High $575.44 | Facility | None | $223.87 | $323.59 | $575.44 |
Regence BlueShield Setting Professional Modifier None (both parts) Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | None (both parts) | $114.82 | $114.82 | $138.04 |
Sanford Health Plan Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $309.03 | Professional | None | $158.49 | $223.87 | $309.03 |
Security Health Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
Security Health Setting Professional Modifier None (both parts) Typical Low $257.04 Median $416.87 Typical High $537.03 | Professional | None (both parts) | $257.04 | $416.87 | $537.03 |
Select Health Setting Facility Modifier None Typical Low $151.36 Median $154.88 Typical High $346.74 | Facility | None | $151.36 | $154.88 | $346.74 |
Select Health Setting Professional Modifier None (both parts) Typical Low $112.20 Median $165.96 Typical High $660.69 | Professional | None (both parts) | $112.20 | $165.96 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $7,413.10 | Facility | None | $128.82 | $194.98 | $7,413.10 |
Sentara Setting Professional Modifier None (both parts) Typical Low $162.18 Median $181.97 Typical High $269.15 | Professional | None (both parts) | $162.18 | $181.97 | $269.15 |
SummaCare Setting Professional Modifier None (both parts) Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | None (both parts) | $138.04 | $162.18 | $181.97 |
The Alliance Setting Professional Modifier None (both parts) Typical Low $190.55 Median $309.03 Typical High $436.52 | Professional | None (both parts) | $190.55 | $309.03 | $436.52 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $501.19 | Professional | None | $138.04 | $218.78 | $501.19 |
UPMC Health Plan Setting Facility Modifier None Typical Low $169.82 Median $309.03 Typical High $436.52 | Facility | None | $169.82 | $309.03 | $436.52 |
UPMC Health Plan Setting Professional Modifier None (both parts) Typical Low $138.04 Median $169.82 Typical High $199.53 | Professional | None (both parts) | $138.04 | $169.82 | $199.53 |
United Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
United Setting Professional Modifier None (both parts) Typical Low $123.03 Median $165.96 Typical High $269.15 | Professional | None (both parts) | $123.03 | $165.96 | $269.15 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $181.97 Typical High $794.33 | Facility | None | $75.86 | $181.97 | $794.33 |
Univera Setting Professional Modifier None (both parts) Typical Low $75.86 Median $112.20 Typical High $194.98 | Professional | None (both parts) | $75.86 | $112.20 | $194.98 |
University Health Alliance Setting Professional Modifier None (both parts) Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | None (both parts) | $190.55 | $223.87 | $223.87 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $234.42 | Facility | None | $109.65 | $151.36 | $234.42 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $100.00 Median $147.91 Typical High $177.83 | Professional | None (both parts) | $100.00 | $147.91 | $177.83 |
Wellmark Setting Professional Modifier None (both parts) Typical Low $181.97 Median $186.21 Typical High $223.87 | Professional | None (both parts) | $181.97 | $186.21 | $223.87 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $104.71 Median $158.49 Typical High $165.96 | Professional | None (both parts) | $104.71 | $158.49 | $165.96 |
72 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 $48.98 Median $74.13 Typical High $91.20 | Facility | 52 · Reduced service | $48.98 | $74.13 | $91.20 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $27.54 | Facility | 55 · Aftercare only | $17.38 | $22.39 | $27.54 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $18.62 | Facility | 56 · Pre-op care only | $11.48 | $14.79 | $18.62 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $123.03 Median $186.21 Typical High $218.78 | Facility | AF · Specialist physician | $123.03 | $186.21 | $218.78 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $93.33 Median $138.04 Typical High $165.96 | Facility | HO · Master's level | $93.33 | $138.04 | $165.96 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $107.15 Median $154.88 Typical High $186.21 | Facility | TD · Registered nurse | $107.15 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $18.20 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $123.03 Median $169.82 Typical High $218.78 | Professional | AF · Specialist physician | $123.03 | $169.82 | $218.78 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $93.33 Median $128.82 Typical High $165.96 | Professional | HO · Master's level | $93.33 | $128.82 | $165.96 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $104.71 Median $144.54 Typical High $190.55 | Professional | TD · Registered nurse | $104.71 | $144.54 | $190.55 |
Ambetter Setting Professional Modifier 24 · Unrelated visit after surgery Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | 24 · Unrelated visit after surgery | $213.80 | $213.80 | $213.80 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $131.83 Median $158.49 Typical High $194.98 | Professional | 25 · Same-day visit | $131.83 | $158.49 | $194.98 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $131.83 Median $131.83 Typical High $323.59 | Professional | 57 · Decision for surgery | $131.83 | $131.83 | $323.59 |
Ambetter Setting Professional Modifier FS · Shared visit Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | FS · Shared visit | $223.87 | $223.87 | $223.87 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $169.82 Median $181.97 Typical High $245.47 | Professional | GC · Resident with teaching physician | $169.82 | $181.97 | $245.47 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | KX · Policy requirements met | $251.19 | $251.19 | $251.19 |
Ambetter Setting Professional Modifier SA · Nurse practitioner Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | SA · Nurse practitioner | $112.20 | $112.20 | $154.88 |
Ambetter Setting Professional Modifier TH · Pregnancy care Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | TH · Pregnancy care | $131.83 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier U7 · State-defined Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | U7 · State-defined | $131.83 | $131.83 | $131.83 |
Ambetter Setting Professional Modifier UD · State-defined Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | UD · State-defined | $173.78 | $173.78 | $173.78 |
Anthem BCBS Setting Professional Modifier EP · Child screening program Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | EP · Child screening program | $138.04 | $138.04 | $181.97 |
BCBS Alabama Setting Professional Modifier 10 + 12 Typical Low $112.20 Median $151.36 Typical High $223.87 | Professional | 10 + 12 | $112.20 | $151.36 | $223.87 |
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $181.97 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $158.49 | $181.97 | $229.09 |
BCBS Minnesota Setting Professional Modifier 25 · Same-day visit Typical Low $147.91 Median $204.17 Typical High $323.59 | Professional | 25 · Same-day visit | $147.91 | $204.17 | $323.59 |
BCBS South Carolina Setting Professional Modifier 29 Typical Low $120.23 Median $162.18 Typical High $239.88 | Professional | 29 | $120.23 | $162.18 | $239.88 |
BCBS Wyoming Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $199.53 | Professional | 53 · Discontinued | $134.90 | $165.96 | $199.53 |
BCBS Wyoming Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $57.54 |
Capital Blue Cross Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $288.40 Typical High $426.58 | Professional | 50 · Both sides | $169.82 | $288.40 | $426.58 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 26 · Professional part | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $117.49 Median $158.49 Typical High $204.17 | Professional | 26 · Professional part | $117.49 | $158.49 | $204.17 |
Emblem Health Setting Professional Modifier HG · Opioid treatment program Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | HG · Opioid treatment program | $104.71 | $104.71 | $104.71 |
Fallon Health Setting Professional Modifier HO · Master's level Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | HO · Master's level | $181.97 | $194.98 | $194.98 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | SA · Nurse practitioner | $181.97 | $194.98 | $194.98 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | U6 · State-defined | $181.97 | $194.98 | $194.98 |
Health Alliance Plan Setting Professional Modifier 25 · Same-day visit Typical Low $316.23 Median $616.60 Typical High $645.65 | Professional | 25 · Same-day visit | $316.23 | $616.60 | $645.65 |
Health Alliance Plan Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | 52 · Reduced service | $72.44 | $72.44 | $87.10 |
Health Alliance Plan Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $26.30 |
Health Alliance Plan Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $17.38 |
Health Alliance Plan Setting Professional Modifier KX · Policy requirements met Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | KX · Policy requirements met | $1,778.28 | $1,778.28 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier HO · Master's level Typical Low $102.33 Median $123.03 Typical High $158.49 | Professional | HO · Master's level | $102.33 | $123.03 | $158.49 |
Martin's Point Setting Facility Modifier 52 · Reduced service Typical Low $3.98 Median $4.79 Typical High $8.71 | Facility | 52 · Reduced service | $3.98 | $4.79 | $8.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.41 Median $8.71 Typical High $81.28 | Professional | 52 · Reduced service | $7.41 | $8.71 | $81.28 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $26.30 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $26.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $11.75 | $14.45 | $17.38 |
Medcost Setting Professional Modifier 26 · Professional part Typical Low $66.07 Median $81.28 Typical High $104.71 | Professional | 26 · Professional part | $66.07 | $81.28 | $104.71 |
Medcost Setting Professional Modifier 50 · Both sides Typical Low $218.78 Median $302.00 Typical High $346.74 | Professional | 50 · Both sides | $218.78 | $302.00 | $346.74 |
Medcost Setting Professional Modifier 51 · Multiple procedures Typical Low $74.13 Median $100.00 Typical High $117.49 | Professional | 51 · Multiple procedures | $74.13 | $100.00 | $117.49 |
Medcost Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $39.81 Typical High $46.77 | Professional | 80 · Assistant surgeon | $29.51 | $39.81 | $46.77 |
Medcost Setting Professional Modifier 81 · Minimal assistant surgeon Typical Low $20.42 Median $28.18 Typical High $32.36 | Professional | 81 · Minimal assistant surgeon | $20.42 | $28.18 | $32.36 |
Medcost Setting Professional Modifier 82 · Assistant surgeon, no resident Typical Low $20.42 Median $28.18 Typical High $32.36 | Professional | 82 · Assistant surgeon, no resident | $20.42 | $28.18 | $32.36 |
Medcost Setting Professional Modifier AS · PA/NP assist Typical Low $20.42 Median $28.18 Typical High $32.36 | Professional | AS · PA/NP assist | $20.42 | $28.18 | $32.36 |
Medcost Setting Professional Modifier TC · Technical part Typical Low $100.00 Median $120.23 Typical High $158.49 | Professional | TC · Technical part | $100.00 | $120.23 | $158.49 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $316.23 Median $501.19 Typical High $630.96 | Professional | 25 · Same-day visit | $316.23 | $501.19 | $630.96 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $47.86 Median $56.23 Typical High $61.66 | Facility | 52 · Reduced service | $47.86 | $56.23 | $61.66 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $14.45 Median $16.98 Typical High $18.62 | Facility | 55 · Aftercare only | $14.45 | $16.98 | $18.62 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.22 Typical High $12.30 | Facility | 56 · Pre-op care only | $9.55 | $11.22 | $12.30 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $190.55 Median $199.53 Typical High $223.87 | Facility | AF · Specialist physician | $190.55 | $199.53 | $223.87 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $144.54 Median $147.91 Typical High $162.18 | Facility | HO · Master's level | $144.54 | $147.91 | $162.18 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $162.18 Median $169.82 Typical High $194.98 | Facility | TD · Registered nurse | $162.18 | $169.82 | $194.98 |
Moda Health Setting Professional Modifier 25 · Same-day visit Typical Low $512.86 Median $616.60 Typical High $691.83 | Professional | 25 · Same-day visit | $512.86 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $58.88 Typical High $107.15 | Professional | 52 · Reduced service | $47.86 | $58.88 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $31.62 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $21.38 |
MountainHealth Co-op Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | 50 · Both sides | $380.19 | $380.19 | $457.09 |
MountainHealth Co-op Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $177.83 | $177.83 | $213.80 |
MountainHealth Co-op Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $30.20 |
MountainHealth Co-op Setting Professional Modifier 62 · Two surgeons Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 62 · Two surgeons | $158.49 | $158.49 | $190.55 |
MountainHealth Co-op Setting Professional Modifier 66 · Surgical team Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 66 · Surgical team | $114.82 | $114.82 | $134.90 |
MountainHealth Co-op Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $190.55 | $229.09 |
Qualchoice Setting Professional Modifier 25 · Same-day visit Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 25 · Same-day visit | $199.53 | $199.53 | $199.53 |
What it costs in each state
The same service costs 2.3 times more in Alaska than in Alabama. 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 $288AL $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.