How much rates vary
Facilitymedian $407 · 10th to 90th $166 to $3,020Professionalmedian $275 · 10th to 90th $13 to $501
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $457.09 | Professional | None | $323.59 | $363.08 | $457.09 |
BCBS Texas Setting Facility Modifier None Typical Low $229.09 Median $407.38 Typical High $1,174.90 | Facility | None | $229.09 | $407.38 | $1,174.90 |
BCBS Texas Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $676.08 | Professional | None | $363.08 | $467.74 | $676.08 |
Christus Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $194.98 Typical High $1,412.54 | Facility | None | $138.04 | $194.98 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $588.84 | Professional | None | $363.08 | $446.68 | $588.84 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,715.35 | Professional | None | $2,884.03 | $2,884.03 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $1,000.00 Typical High $4,570.88 | Facility | None | $363.08 | $1,000.00 | $4,570.88 |
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 $67.61 Typical High $407.38 | Professional | None | $10.96 | $67.61 | $407.38 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $436.52 Typical High $3,801.89 | Facility | None | $158.49 | $436.52 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $588.84 | Professional | None | $363.08 | $446.68 | $588.84 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
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 $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $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 $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $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 $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $245.47 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $48.98 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $32.36 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $229.09 | $257.04 | $295.12 |
Where Texas sits
The same service costs 5.3 times more in New York than in Maryland. 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
NY $3,010MD $572
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.