How much rates vary
Facilitymedian $10,000 · 10th to 90th $1,995 to $24,547Professionalmedian $309 · 10th to 90th $44 to $3,631
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 $977.24 Median $3,311.31 Typical High $10,471.29 | Facility | None | $977.24 | $3,311.31 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $3,235.94 | Professional | None | $331.13 | $380.19 | $3,235.94 |
BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $16,982.44 Typical High $38,018.94 | Facility | None | $8,912.51 | $16,982.44 | $38,018.94 |
BCBS Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $616.60 | Professional | None | $302.00 | $389.05 | $616.60 |
Christus Setting Facility Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,000.00 | Facility | None | $10,000.00 | $10,000.00 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $9,549.93 Typical High $15,848.93 | Facility | None | $707.95 | $9,549.93 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $660.69 | Professional | None | $316.23 | $416.87 | $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 $3,630.78 Median $5,754.40 Typical High $5,754.40 | Professional | None | $3,630.78 | $5,754.40 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $2,511.89 Typical High $6,918.31 | Facility | None | $380.19 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $549.54 | Professional | None | $331.13 | $380.19 | $549.54 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $208.93 Typical High $309.03 | Professional | None | $38.02 | $208.93 | $309.03 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $7,244.36 Typical High $13,489.63 | Facility | None | $575.44 | $7,244.36 | $13,489.63 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $660.69 | Professional | None | $316.23 | $426.58 | $660.69 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $10,232.93 Typical High $26,302.68 | Facility | None | $3,981.07 | $10,232.93 | $26,302.68 |
United Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $602.56 | Professional | None | $269.15 | $389.05 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $165.96 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $66.07 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $181.97 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $74.13 Typical High $81.28 | Professional | 53 · Discontinued | $66.07 | $74.13 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $275.42 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $37.15 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.11 | $37.15 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $288.40 |
Where Texas sits
The same service costs 22.3 times more in Oklahoma 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
OK $22,356MT $1,003
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.