How much rates vary
Facilitymedian $2,188 · 10th to 90th $708 to $5,370Professionalmedian $324 · 10th to 90th $26 to $603
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $537.03 | Professional | None | $316.23 | $426.58 | $537.03 |
BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $2,511.89 Typical High $5,248.07 | Facility | None | $1,412.54 | $2,511.89 | $5,248.07 |
BCBS Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $758.58 | Professional | None | $363.08 | $489.78 | $758.58 |
Christus Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $630.96 | Professional | None | $380.19 | $489.78 | $630.96 |
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 $3,548.13 Median $3,548.13 Typical High $4,786.30 | Professional | None | $3,548.13 | $3,548.13 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,174.90 Typical High $4,786.30 | Facility | None | $426.58 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $537.03 | Professional | None | $316.23 | $426.58 | $537.03 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $95.50 Typical High $501.19 | Professional | None | $17.78 | $95.50 | $501.19 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $4,466.84 | Facility | None | $501.19 | $1,000.00 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $630.96 | Professional | None | $380.19 | $489.78 | $630.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $602.56 | Professional | None | $295.12 | $407.38 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $158.49 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $158.49 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $63.10 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $316.23 Typical High $398.11 | Professional | 54 · Surgery only | $234.42 | $316.23 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $79.43 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $158.49 | $213.80 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $102.33 | Professional | 53 · Discontinued | $63.10 | $85.11 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $316.23 Typical High $380.19 | Professional | 54 · Surgery only | $234.42 | $316.23 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $47.86 | $63.10 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $42.66 Typical High $51.29 | Professional | 56 · Pre-op care only | $31.62 | $42.66 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $295.12 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $223.87 | $295.12 | $354.81 |
Where Texas sits
The same service costs 3.7 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 $4,890MT $1,327
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.