How much rates vary
Facilitymedian $1,175 · 10th to 90th $19 to $3,981Professionalmedian $407 · 10th to 90th $38 to $646
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 $275.42 Median $446.68 Typical High $575.44 | Professional | None | $275.42 | $446.68 | $575.44 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $3,801.89 | Facility | None | $691.83 | $1,412.54 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $794.33 | Professional | None | $309.03 | $489.78 | $794.33 |
Christus Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
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 $346.74 Median $467.74 Typical High $660.69 | Professional | None | $346.74 | $467.74 | $660.69 |
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 $4,786.30 | Professional | None | $3,630.78 | $3,630.78 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $1,174.90 Typical High $4,786.30 | Facility | None | $309.03 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $575.44 | Professional | None | $275.42 | $446.68 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $354.81 Typical High $562.34 | Professional | None | $33.11 | $354.81 | $562.34 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $1,000.00 Typical High $4,466.84 | Facility | None | $457.09 | $1,000.00 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $660.69 | Professional | None | $346.74 | $467.74 | $660.69 |
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 $229.09 Median $371.54 Typical High $588.84 | Professional | None | $229.09 | $371.54 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
13 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 $138.04 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $138.04 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $54.95 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $208.93 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $27.54 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $194.98 | $316.23 | $380.19 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 50 · Both sides | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $138.04 | $223.87 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $54.95 | $89.13 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $208.93 | $338.84 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $67.61 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $27.54 | $44.67 | $53.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $194.98 | $316.23 | $380.19 |
Where Texas sits
The same service costs 4.5 times more in Colorado than in Maryland. 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 $4,866MD $1,088
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.