How much rates vary
Facilitymedian $1,413 · 10th to 90th $407 to $3,715Professionalmedian $339 · 10th to 90th $26 to $589
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $537.03 | Professional | None | $346.74 | $416.87 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $812.83 Median $1,548.82 Typical High $3,801.89 | Facility | None | $812.83 | $1,548.82 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $776.25 | Professional | None | $389.05 | $501.19 | $776.25 |
Christus Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,659.59 | Facility | None | $457.09 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $645.65 | Professional | None | $398.11 | $501.19 | $645.65 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,677.35 | Professional | None | $3,388.44 | $3,388.44 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,288.25 Typical High $4,365.16 | Facility | None | $426.58 | $1,288.25 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $645.65 | Professional | None | $354.81 | $416.87 | $645.65 |
Molina Setting Professional Modifier None Typical Low $17.78 Median $93.33 Typical High $489.78 | Professional | None | $17.78 | $93.33 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,659.59 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $1,096.48 Typical High $3,801.89 | Facility | None | $436.52 | $1,096.48 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $645.65 | Professional | None | $398.11 | $501.19 | $645.65 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $630.96 | Professional | None | $323.59 | $416.87 | $630.96 |
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 $173.78 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $173.78 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $257.04 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $239.88 | $288.40 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $208.93 Typical High $239.88 | Professional | 52 · Reduced service | $173.78 | $208.93 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $69.18 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $309.03 Typical High $363.08 | Professional | 54 · Surgery only | $257.04 | $309.03 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $63.10 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $63.10 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $34.67 | $41.69 | $47.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $288.40 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $239.88 | $288.40 | $338.84 |
Where Texas sits
The same service costs 4.9 times more in Colorado than in Delaware. 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 $4,364DE $899
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.