How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,202 to $6,457Professionalmedian $380 · 10th to 90th $27 to $692
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 $954.99 Median $4,073.80 Typical High $10,964.78 | Facility | None | $954.99 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $691.83 | Professional | None | $338.84 | $512.86 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
BCBS Texas Setting Facility Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $6,456.54 | Facility | None | $1,202.26 | $2,570.40 | $6,456.54 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $933.25 | Professional | None | $380.19 | $562.34 | $933.25 |
Christus Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $4,265.80 | Facility | None | $1,148.15 | $1,621.81 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $812.83 | Professional | None | $426.58 | $588.84 | $812.83 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $5,495.41 | Professional | None | $4,265.80 | $4,265.80 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $1,819.70 Typical High $6,918.31 | Facility | None | $407.38 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $812.83 | Professional | None | $338.84 | $512.86 | $812.83 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $114.82 Typical High $575.44 | Professional | None | $21.38 | $114.82 | $575.44 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,698.24 Typical High $9,772.37 | Facility | None | $616.60 | $1,698.24 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $812.83 | Professional | None | $416.87 | $588.84 | $812.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $776.25 | Professional | None | $331.13 | $501.19 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $169.82 Median $257.04 Typical High $316.23 | Professional | 52 · Reduced service | $169.82 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $102.33 Typical High $125.89 | Professional | 53 · Discontinued | $67.61 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $467.74 | Professional | 54 · Surgery only | $251.19 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $93.33 | Professional | 55 · Aftercare only | $50.12 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $51.29 Typical High $63.10 | Professional | 56 · Pre-op care only | $33.88 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $169.82 | $257.04 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $67.61 | $102.33 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $251.19 | $380.19 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $50.12 | $75.86 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $33.88 | $51.29 | $61.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $234.42 | $354.81 | $426.58 |
Where Texas sits
The same service costs 4.3 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 $6,505MT $1,512
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.