How much rates vary
Facilitymedian $589 · 10th to 90th $269 to $2,754Professionalmedian $209 · 10th to 90th $35 to $437
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 $660.69 Median $2,630.27 Typical High $6,918.31 | Facility | None | $660.69 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $446.68 | Professional | None | $154.88 | $288.40 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $134.90 | Professional | None | $67.61 | $67.61 | $134.90 |
BCBS Texas Setting Facility Modifier None Typical Low $281.84 Median $549.54 Typical High $1,698.24 | Facility | None | $281.84 | $549.54 | $1,698.24 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $389.05 | Professional | None | $138.04 | $251.19 | $389.05 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $1,862.09 | Facility | None | $288.40 | $416.87 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $407.38 | Professional | None | $151.36 | $281.84 | $407.38 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,238.72 | $2,754.23 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $1,202.26 Typical High $4,677.35 | Facility | None | $169.82 | $1,202.26 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $446.68 | Professional | None | $154.88 | $263.03 | $446.68 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $128.82 Typical High $295.12 | Professional | None | $30.90 | $128.82 | $295.12 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $489.78 Typical High $4,466.84 | Facility | None | $281.84 | $489.78 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $281.84 Typical High $407.38 | Professional | None | $151.36 | $281.84 | $407.38 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $371.54 | Professional | None | $117.49 | $223.87 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $77.62 Median $144.54 Typical High $190.55 | Professional | 52 · Reduced service | $77.62 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $30.90 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $117.49 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $23.44 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $15.49 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $109.65 | $204.17 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $144.54 Typical High $190.55 | Professional | 52 · Reduced service | $77.62 | $144.54 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $30.90 | $57.54 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $117.49 | $218.78 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $43.65 Typical High $57.54 | Professional | 55 · Aftercare only | $23.44 | $43.65 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $15.49 | $28.84 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $204.17 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $109.65 | $204.17 | $269.15 |
Where Texas sits
The same service costs 5.2 times more in New York 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
NY $2,881MD $549
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.