How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,318 to $13,183Professionalmedian $166 · 10th to 90th $23 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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | None | $512.86 | $575.44 | $891.25 |
BCBS Texas Setting Facility Modifier None Typical Low $5,011.87 Median $9,772.37 Typical High $21,379.62 | Facility | None | $5,011.87 | $9,772.37 | $21,379.62 |
BCBS Texas Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $977.24 | Professional | None | $575.44 | $724.44 | $977.24 |
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 $691.83 Median $5,370.32 Typical High $7,585.78 | Facility | None | $691.83 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $912.01 | Professional | None | $562.34 | $707.95 | $912.01 |
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 $4,466.84 Median $4,466.84 Typical High $5,128.61 | Professional | None | $4,466.84 | $4,466.84 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $6,025.60 | Facility | None | $602.56 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $891.25 | Professional | None | $512.86 | $575.44 | $891.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $112.20 Typical High $537.03 | Professional | None | $21.88 | $112.20 | $537.03 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $5,128.61 Typical High $7,762.47 | Facility | None | $660.69 | $5,128.61 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $912.01 | Professional | None | $562.34 | $707.95 | $912.01 |
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 $478.63 Median $602.56 Typical High $933.25 | Professional | None | $478.63 | $602.56 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $257.04 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $426.58 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $398.11 | $457.09 |
Where Texas sits
The same service costs 6.0 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 $12,071MT $2,001
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.