How much rates vary
Facilitymedian $1,698 · 10th to 90th $813 to $4,467Professionalmedian $240 · 10th to 90th $32 to $468
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 $1,000.00 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $501.19 | Professional | None | $338.84 | $380.19 | $501.19 |
BCBS Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $3,715.35 | Facility | None | $912.01 | $1,621.81 | $3,715.35 |
BCBS Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $630.96 | Professional | None | $371.54 | $467.74 | $630.96 |
Christus Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,818.38 | Facility | None | $870.96 | $1,445.44 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $645.65 | Professional | None | $363.08 | $457.09 | $645.65 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,951.21 | $2,951.21 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $2,511.89 Typical High $6,760.83 | Facility | None | $371.54 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $501.19 | Professional | None | $338.84 | $380.19 | $501.19 |
Molina Setting Professional Modifier None Typical Low $13.80 Median $70.79 Typical High $346.74 | Professional | None | $13.80 | $70.79 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,318.26 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,621.81 Typical High $6,760.83 | Facility | None | $660.69 | $1,621.81 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $645.65 | Professional | None | $363.08 | $457.09 | $645.65 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $616.60 | Professional | None | $309.03 | $407.38 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $169.82 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $181.97 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $74.13 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $42.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $295.12 |
Where Texas sits
The same service costs 4.0 times more in Colorado than in West Virginia. 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 $4,927WV $1,231
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.