How much rates vary
Facilitymedian $2,239 · 10th to 90th $724 to $5,623Professionalmedian $112 · 10th to 90th $18 to $575
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $645.65 | Professional | None | $416.87 | $467.74 | $645.65 |
BCBS Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $1,819.70 | Professional | None | $467.74 | $602.56 | $1,819.70 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,691.53 | Facility | None | $602.56 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $812.83 | Professional | None | $478.63 | $575.44 | $812.83 |
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 $3,630.78 Median $3,630.78 Typical High $4,466.84 | Professional | None | $3,630.78 | $3,630.78 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,905.46 Typical High $5,495.41 | Facility | None | $524.81 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $660.69 | Professional | None | $416.87 | $478.63 | $660.69 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $89.13 Typical High $457.09 | Professional | None | $16.98 | $89.13 | $457.09 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $2,041.74 Typical High $4,466.84 | Facility | None | $575.44 | $2,041.74 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | None | $457.09 | $575.44 | $812.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $794.33 | Professional | None | $398.11 | $524.81 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $208.93 Median $234.42 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $85.11 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $407.38 | Professional | 54 · Surgery only | $316.23 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $234.42 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $93.33 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $354.81 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $331.13 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $331.13 | $371.54 |
Where Texas sits
The same service costs 4.0 times more in Oklahoma 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
OK $6,769MT $1,704
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.