How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,230 to $6,607Professionalmedian $316 · 10th to 90th $18 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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $7,244.36 | Facility | None | $1,412.54 | $2,818.38 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $933.25 | Professional | None | $549.54 | $691.83 | $933.25 |
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 Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,691.53 | Facility | None | $602.56 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $977.24 | Professional | None | $562.34 | $676.08 | $977.24 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,905.46 Typical High $5,623.41 | Facility | None | $588.84 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $93.33 Typical High $512.86 | Professional | None | $16.98 | $93.33 | $512.86 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $4,466.84 | Facility | None | $602.56 | $2,041.74 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $933.25 | Professional | None | $467.74 | $616.60 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $251.19 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $109.65 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $416.87 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $436.52 |
Where Texas sits
The same service costs 3.6 times more in Oklahoma 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
OK $6,890MT $1,932
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.