How much rates vary
Facilitymedian $1,862 · 10th to 90th $977 to $5,248Professionalmedian $195 · 10th to 90th $12 to $457
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 $1,000.00 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $562.34 | Professional | None | $331.13 | $371.54 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $537.03 | Professional | None | $363.08 | $363.08 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $1,071.52 Median $1,949.84 Typical High $4,073.80 | Facility | None | $1,071.52 | $1,949.84 | $4,073.80 |
BCBS Texas Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $660.69 | Professional | None | $371.54 | $467.74 | $660.69 |
Christus Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,818.38 | Facility | None | $812.83 | $1,122.02 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $602.56 | Professional | None | $363.08 | $457.09 | $602.56 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,884.03 | $2,884.03 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $3,019.95 Typical High $6,918.31 | Facility | None | $416.87 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $524.81 | Professional | None | $331.13 | $371.54 | $524.81 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $64.57 Typical High $371.54 | Professional | None | $10.96 | $64.57 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,380.38 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $6,760.83 | Facility | None | $660.69 | $1,258.93 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $602.56 | Professional | None | $363.08 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $602.56 | Professional | None | $302.00 | $389.05 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $165.96 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $181.97 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $72.44 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $269.15 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $53.70 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $295.12 |
Where Texas sits
The same service costs 3.9 times more in Colorado than in Montana. 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 $5,016MT $1,277
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.