How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,413 to $7,244Professionalmedian $209 · 10th to 90th $30 to $912
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 $1,096.48 Median $3,715.35 Typical High $10,232.93 | Facility | None | $1,096.48 | $3,715.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,202.26 | Professional | None | $707.95 | $831.76 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $724.44 Typical High $758.58 | Professional | None | $380.19 | $724.44 | $758.58 |
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 $776.25 Median $977.24 Typical High $1,348.96 | Professional | None | $776.25 | $977.24 | $1,348.96 |
Christus Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $776.25 Median $954.99 Typical High $1,348.96 | Professional | None | $776.25 | $954.99 | $1,348.96 |
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 $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Moda Health Setting Facility Modifier None Typical Low $851.14 Median $3,467.37 Typical High $8,317.64 | Facility | None | $851.14 | $3,467.37 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,174.90 | Professional | None | $707.95 | $851.14 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $141.25 Typical High $707.95 | Professional | None | $26.92 | $141.25 | $707.95 |
Oscar Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,884.03 Typical High $3,019.95 | Professional | None | $2,754.23 | $2,884.03 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $6,165.95 | Facility | None | $758.58 | $2,187.76 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,348.96 | Professional | None | $758.58 | $954.99 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,000.00 | Facility | None | $1,698.24 | $4,570.88 | $10,000.00 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,318.26 | Professional | None | $660.69 | $851.14 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $354.81 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $389.05 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $154.88 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $575.44 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $616.60 |
Where Texas sits
The same service costs 3.2 times more in Wisconsin than in Maryland. 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
WI $8,354MD $2,629
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.