How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,413 to $7,586Professionalmedian $282 · 10th to 90th $18 to $589
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 $1,000.00 Median $3,715.35 Typical High $10,232.93 | Facility | None | $1,000.00 | $3,715.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $707.95 | Professional | None | $457.09 | $524.81 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
BCBS Texas Setting Facility Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $7,585.78 | Facility | None | $1,513.56 | $3,019.95 | $7,585.78 |
BCBS Texas Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $870.96 | Professional | None | $457.09 | $524.81 | $870.96 |
Baylor Scott & White Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $870.96 | Professional | None | $501.19 | $588.84 | $870.96 |
Christus Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $2,818.38 | Facility | None | $691.83 | $2,089.30 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $933.25 | Professional | None | $524.81 | $616.60 | $933.25 |
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 $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $3,981.07 Typical High $8,317.64 | Facility | None | $776.25 | $3,981.07 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $724.44 | Professional | None | $457.09 | $524.81 | $724.44 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $89.13 Typical High $457.09 | Professional | None | $16.22 | $89.13 | $457.09 |
Oscar Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $7,244.36 | Facility | None | $1,513.56 | $1,778.28 | $7,244.36 |
Oscar Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,819.70 | $1,862.09 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $2,187.76 Typical High $6,165.95 | Facility | None | $645.65 | $2,187.76 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $489.78 Median $616.60 Typical High $933.25 | Professional | None | $489.78 | $616.60 | $933.25 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $4,677.35 Typical High $10,000.00 | Facility | None | $1,737.80 | $4,677.35 | $10,000.00 |
United Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $891.25 | Professional | None | $446.68 | $575.44 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $229.09 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $371.54 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $398.11 |
Where Texas sits
The same service costs 4.7 times more in Connecticut 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
CT $8,304MT $1,762
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.