How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,148 to $13,183Professionalmedian $166 · 10th to 90th $23 to $794
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 $575.44 Median $645.65 Typical High $851.14 | Professional | None | $575.44 | $645.65 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $9,772.37 Typical High $21,379.62 | Facility | None | $4,365.16 | $9,772.37 | $21,379.62 |
BCBS Texas Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $1,122.02 | Professional | None | $645.65 | $812.83 | $1,122.02 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $4,168.69 Typical High $6,025.60 | Facility | None | $602.56 | $4,168.69 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,047.13 | Professional | None | $630.96 | $794.33 | $1,047.13 |
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 $5,011.87 Median $5,011.87 Typical High $5,754.40 | Professional | None | $5,011.87 | $5,011.87 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $5,495.41 | Facility | None | $645.65 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $851.14 | Professional | None | $575.44 | $645.65 | $851.14 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $602.56 | Professional | None | $21.88 | $117.49 | $602.56 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $3,890.45 Typical High $5,888.44 | Facility | None | $630.96 | $3,890.45 | $5,888.44 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,047.13 | Professional | None | $630.96 | $794.33 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,232.93 | Facility | None | $1,698.24 | $4,570.88 | $10,232.93 |
United Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,047.13 | Professional | None | $537.03 | $676.08 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $288.40 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $288.40 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $114.82 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $288.40 | $316.23 | $363.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $114.82 | $125.89 | $144.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $478.63 | $549.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $87.10 | $95.50 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $72.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $512.86 |
Where Texas sits
The same service costs 5.2 times more in Colorado than in Hawaii. 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 $11,188HI $2,150
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.