How much rates vary
Facilitymedian $1,380 · 10th to 90th $617 to $4,169Professionalmedian $427 · 10th to 90th $52 to $708
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 $562.34 Median $3,162.28 Typical High $7,943.28 | Facility | None | $562.34 | $3,162.28 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $741.31 | Professional | None | $436.52 | $512.86 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $616.60 Typical High $794.33 | Professional | None | $316.23 | $616.60 | $794.33 |
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 $436.52 Median $537.03 Typical High $851.14 | Professional | None | $436.52 | $537.03 | $851.14 |
Baylor Scott & White Setting Facility Modifier None Typical Low $165.96 Median $1,621.81 Typical High $3,235.94 | Facility | None | $165.96 | $1,621.81 | $3,235.94 |
Baylor Scott & White Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,862.09 | Professional | None | $537.03 | $812.83 | $1,862.09 |
Christus Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,691.53 | Facility | None | $691.83 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $831.76 | Professional | None | $501.19 | $588.84 | $831.76 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,495.41 | Professional | None | $3,981.07 | $3,981.07 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,318.26 Typical High $5,248.07 | Facility | None | $537.03 | $1,318.26 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $794.33 | Professional | None | $436.52 | $524.81 | $794.33 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $100.00 Typical High $562.34 | Professional | None | $16.22 | $100.00 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,398.83 | Professional | None | $1,949.84 | $2,089.30 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,174.90 Typical High $6,165.95 | Facility | None | $616.60 | $1,174.90 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $831.76 | Professional | None | $489.78 | $588.84 | $831.76 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Professional | None | $416.87 | $537.03 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $218.78 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $87.10 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $323.59 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $218.78 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $87.10 | $100.00 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $323.59 | $380.19 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $407.38 |
Where Texas sits
The same service costs 4.0 times more in Colorado than in Florida. 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 $4,440FL $1,118
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.