How much rates vary
Facilitymedian $5,623 · 10th to 90th $2,188 to $12,023Professionalmedian $355 · 10th to 90th $23 to $851
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $977.24 | Professional | None | $630.96 | $707.95 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $3,090.30 Median $6,025.60 Typical High $15,135.61 | Facility | None | $3,090.30 | $6,025.60 | $15,135.61 |
BCBS Texas Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,258.93 | Professional | None | $691.83 | $891.25 | $1,258.93 |
Christus Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,265.80 Typical High $6,025.60 | Facility | None | $691.83 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,148.15 | Professional | None | $691.83 | $851.14 | $1,148.15 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,165.95 | Professional | None | $5,495.41 | $5,495.41 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $3,467.37 Typical High $11,481.54 | Facility | None | $724.44 | $3,467.37 | $11,481.54 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,000.00 | Professional | None | $630.96 | $724.44 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $120.23 Typical High $630.96 | Professional | None | $21.88 | $120.23 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,570.40 Typical High $2,691.53 | Professional | None | $2,511.89 | $2,570.40 | $2,691.53 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $6,606.93 | Facility | None | $707.95 | $4,168.69 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,148.15 | Professional | None | $691.83 | $851.14 | $1,148.15 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,187.76 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,148.15 | Professional | None | $575.44 | $758.58 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $316.23 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $346.74 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $467.74 | $512.86 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $549.54 |
Where Texas sits
The same service costs 5.6 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 $13,636HI $2,423
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.