How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,318 to $6,761Professionalmedian $447 · 10th to 90th $51 to $794
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 $724.44 Median $3,235.94 Typical High $8,511.38 | Facility | None | $724.44 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $776.25 | Professional | None | $389.05 | $588.84 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $489.78 | Professional | None | $407.38 | $426.58 | $489.78 |
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 $426.58 Median $630.96 Typical High $977.24 | Professional | None | $426.58 | $630.96 | $977.24 |
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 $489.78 Median $691.83 Typical High $977.24 | Professional | None | $489.78 | $691.83 | $977.24 |
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 $5,011.87 Median $5,011.87 Typical High $6,025.60 | Professional | None | $5,011.87 | $5,011.87 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $3,548.13 Typical High $7,943.28 | Facility | None | $645.65 | $3,548.13 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $776.25 | Professional | None | $389.05 | $588.84 | $776.25 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $120.23 Typical High $645.65 | Professional | None | $21.38 | $120.23 | $645.65 |
Oscar Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,659.59 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,041.74 Typical High $6,165.95 | Facility | None | $630.96 | $2,041.74 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $977.24 | Professional | None | $489.78 | $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 $407.38 Median $630.96 Typical High $912.01 | Professional | None | $407.38 | $630.96 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
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 $194.98 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $194.98 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $117.49 Typical High $147.91 | Professional | 53 · Discontinued | $77.62 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $549.54 | Professional | 54 · Surgery only | $288.40 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $89.13 Typical High $112.20 | Professional | 55 · Aftercare only | $57.54 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $58.88 Typical High $74.13 | Professional | 56 · Pre-op care only | $38.90 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $295.12 Typical High $354.81 | Professional | 52 · Reduced service | $194.98 | $295.12 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $117.49 Typical High $141.25 | Professional | 53 · Discontinued | $77.62 | $117.49 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $524.81 | Professional | 54 · Surgery only | $288.40 | $436.52 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $57.54 | $89.13 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $58.88 Typical High $70.79 | Professional | 56 · Pre-op care only | $38.90 | $58.88 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $489.78 |
Where Texas sits
The same service costs 6.0 times more in Alabama than in West Virginia. 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
AL $8,344WV $1,400
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.