How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,148 to $5,754Professionalmedian $316 · 10th to 90th $28 to $550
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 $645.65 Median $2,630.27 Typical High $6,918.31 | Facility | None | $645.65 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $575.44 | Professional | None | $218.78 | $309.03 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $316.23 | Professional | None | $302.00 | $302.00 | $316.23 |
BCBS Texas Setting Facility Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,202.26 | $2,570.40 | $6,309.57 |
BCBS Texas Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $602.56 | Professional | None | $269.15 | $389.05 | $602.56 |
Christus Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,187.76 | Facility | None | $602.56 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,951.21 | $2,951.21 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $1,819.70 Typical High $5,754.40 | Facility | None | $309.03 | $1,819.70 | $5,754.40 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $575.44 | Professional | None | $218.78 | $309.03 | $575.44 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $66.07 Typical High $407.38 | Professional | None | $5.89 | $66.07 | $407.38 |
Providence Setting Facility Modifier None Typical Low $416.87 Median $1,548.82 Typical High $4,466.84 | Facility | None | $416.87 | $1,548.82 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $549.54 | Professional | None | $281.84 | $389.05 | $549.54 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $524.81 | Professional | None | $245.47 | $346.74 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
12 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 Professional Modifier 52 · Reduced service Typical Low $109.65 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $165.96 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $154.88 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $63.10 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $63.10 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $165.96 | $234.42 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $30.90 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $154.88 | $218.78 | $269.15 |
Where Texas sits
The same service costs 6.1 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $6,346MT $1,043
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.