How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,413 to $8,511Professionalmedian $145 · 10th to 90th $23 to $759
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 $602.56 Median $660.69 Typical High $912.01 | Professional | None | $602.56 | $660.69 | $912.01 |
BCBS Texas Setting Facility Modifier None Typical Low $1,445.44 Median $3,019.95 Typical High $7,244.36 | Facility | None | $1,445.44 | $3,019.95 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,202.26 | Professional | None | $660.69 | $851.14 | $1,202.26 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,412.54 | $1,778.28 |
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 $5,754.40 Median $6,309.57 Typical High $6,309.57 | Professional | None | $5,754.40 | $6,309.57 | $6,309.57 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $6,918.31 | Facility | None | $707.95 | $2,818.38 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $912.01 | Professional | None | $602.56 | $660.69 | $912.01 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $602.56 | Professional | None | $21.88 | $117.49 | $602.56 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $1,380.38 | Facility | None | $645.65 | $954.99 | $1,380.38 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,288.25 Typical High $1,479.11 | Professional | None | $79.43 | $1,288.25 | $1,479.11 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,174.90 | Professional | None | $562.34 | $741.31 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $302.00 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $131.83 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $501.19 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $524.81 |
Where Texas sits
The same service costs 4.4 times more in Wisconsin 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
WI $9,724MT $2,195
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.