How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,259 to $6,607Professionalmedian $295 · 10th to 90th $26 to $550
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 $707.95 Median $3,235.94 Typical High $8,511.38 | Facility | None | $707.95 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $524.81 | Professional | None | $269.15 | $416.87 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $302.00 | Professional | None | $158.49 | $158.49 | $302.00 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,951.21 Typical High $7,244.36 | Facility | None | $1,412.54 | $2,951.21 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $707.95 | Professional | None | $302.00 | $436.52 | $707.95 |
Christus Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $2,754.23 | Facility | None | $691.83 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $660.69 | Professional | None | $338.84 | $478.63 | $660.69 |
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 $3,467.37 Median $3,467.37 Typical High $4,265.80 | Professional | None | $3,467.37 | $3,467.37 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $1,778.28 Typical High $6,025.60 | Facility | None | $363.08 | $1,778.28 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $416.87 Typical High $524.81 | Professional | None | $269.15 | $416.87 | $524.81 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $89.13 Typical High $436.52 | Professional | None | $16.98 | $89.13 | $436.52 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $2,041.74 Typical High $6,165.95 | Facility | None | $478.63 | $2,041.74 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $660.69 | Professional | None | $331.13 | $467.74 | $660.69 |
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 $263.03 Median $389.05 Typical High $602.56 | Professional | None | $263.03 | $389.05 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $134.90 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $134.90 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $53.70 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $204.17 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $40.74 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $190.55 | $288.40 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $134.90 | $208.93 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $53.70 | $83.18 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $204.17 | $309.03 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $40.74 | $61.66 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $288.40 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $190.55 | $288.40 | $346.74 |
Where Texas sits
The same service costs 11.0 times more in Vermont 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
VT $12,892MT $1,170
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.