How much rates vary
Facilitymedian $3,631 · 10th to 90th $832 to $10,233Professionalmedian $170 · 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 $776.25 Median $3,715.35 Typical High $9,120.11 | Facility | None | $776.25 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $794.33 | Professional | None | $616.60 | $691.83 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
BCBS Texas Setting Facility Modifier None Typical Low $758.58 Median $1,445.44 Typical High $7,762.47 | Facility | None | $758.58 | $1,445.44 | $7,762.47 |
BCBS Texas Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,202.26 | Professional | None | $707.95 | $891.25 | $1,202.26 |
Christus Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $7,762.47 Typical High $10,964.78 | Facility | None | $758.58 | $7,762.47 | $10,964.78 |
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 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,309.57 | Professional | None | $5,623.41 | $5,623.41 | $6,309.57 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $6,918.31 | Facility | None | $691.83 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $933.25 | Professional | None | $616.60 | $691.83 | $933.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $125.89 Typical High $676.08 | Professional | None | $21.88 | $125.89 | $676.08 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $7,585.78 Typical High $10,964.78 | Facility | None | $691.83 | $7,585.78 | $10,964.78 |
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 $2,630.27 Median $6,165.95 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,165.95 | $15,848.93 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,148.15 | Professional | None | $575.44 | $741.31 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $309.03 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $134.90 | $158.49 |
Aetna 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 |
Aetna 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 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $79.43 |
Aetna 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 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $338.84 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $134.90 | $154.88 |
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 $61.66 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $77.62 |
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 7.4 times more in Alabama than in Kentucky. 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
AL $14,977KY $2,013
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.