How much rates vary
Facilitymedian $1,862 · 10th to 90th $955 to $4,677Professionalmedian $78 · 10th to 90th $11 to $417
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 $323.59 Median $363.08 Typical High $524.81 | Professional | None | $323.59 | $363.08 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $537.03 | Professional | None | $446.68 | $446.68 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $4,265.80 | Facility | None | $1,071.52 | $1,995.26 | $4,265.80 |
BCBS Texas Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $630.96 | Professional | None | $363.08 | $457.09 | $630.96 |
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 $602.56 Median $1,122.02 Typical High $2,089.30 | Facility | None | $602.56 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $602.56 | Professional | None | $354.81 | $446.68 | $602.56 |
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 $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $2,511.89 Typical High $5,128.61 | Facility | None | $446.68 | $2,511.89 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $501.19 | Professional | None | $323.59 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $61.66 Typical High $338.84 | Professional | None | $10.96 | $61.66 | $338.84 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,202.26 Typical High $4,466.84 | Facility | None | $537.03 | $1,202.26 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $602.56 | Professional | None | $354.81 | $446.68 | $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 $295.12 Median $389.05 Typical High $588.84 | Professional | None | $295.12 | $389.05 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $162.18 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $83.18 | Professional | 53 · Discontinued | $64.57 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $177.83 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $70.79 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $269.15 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $288.40 |
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 $4,902MT $1,262
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.