How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,738 to $12,303Professionalmedian $209 · 10th to 90th $30 to $1,000
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 $758.58 Median $831.76 Typical High $1,096.48 | Professional | None | $758.58 | $831.76 | $1,096.48 |
BCBS Texas Setting Facility Modifier None Typical Low $3,090.30 Median $6,606.93 Typical High $15,848.93 | Facility | None | $3,090.30 | $6,606.93 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,412.54 | Professional | None | $794.33 | $1,023.29 | $1,412.54 |
Christus Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $5,370.32 Typical High $7,585.78 | Facility | None | $870.96 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,318.26 | Professional | None | $794.33 | $1,000.00 | $1,318.26 |
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 $6,309.57 Median $6,309.57 Typical High $7,413.10 | Professional | None | $6,309.57 | $6,309.57 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $6,760.83 | Facility | None | $812.83 | $2,454.71 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,096.48 | Professional | None | $758.58 | $851.14 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $144.54 Typical High $758.58 | Professional | None | $26.92 | $144.54 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,090.30 Typical High $3,235.94 | Professional | None | $2,951.21 | $3,090.30 | $3,235.94 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $5,248.07 Typical High $7,762.47 | Facility | None | $851.14 | $5,248.07 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $776.25 | $1,000.00 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,232.93 | Facility | None | $1,698.24 | $4,570.88 | $10,232.93 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,318.26 | Professional | None | $660.69 | $851.14 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $616.60 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $676.08 |
Where Texas sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.