How much rates vary
Facilitymedian $2,239 · 10th to 90th $661 to $5,129Professionalmedian $355 · 10th to 90th $48 to $2,884
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 $851.14 Median $2,818.38 Typical High $7,585.78 | Facility | None | $851.14 | $2,818.38 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $3,019.95 | Professional | None | $407.38 | $457.09 | $3,019.95 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
BCBS Texas Setting Facility Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $6,606.93 | Facility | None | $1,584.89 | $2,951.21 | $6,606.93 |
BCBS Texas Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $724.44 | Professional | None | $371.54 | $467.74 | $724.44 |
Christus Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $2,754.23 | Facility | None | $602.56 | $1,445.44 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $724.44 | Professional | None | $389.05 | $512.86 | $724.44 |
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 $2,884.03 Median $2,884.03 Typical High $3,162.28 | Professional | None | $2,884.03 | $2,884.03 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $6,918.31 | Facility | None | $457.09 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $724.44 | Professional | None | $407.38 | $457.09 | $724.44 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $245.47 Typical High $354.81 | Professional | None | $40.74 | $245.47 | $354.81 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $4,466.84 | Facility | None | $562.34 | $1,513.56 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $724.44 | Professional | None | $380.19 | $512.86 | $724.44 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $707.95 | Professional | None | $323.59 | $457.09 | $707.95 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $204.17 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $81.28 | $89.13 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $338.84 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $346.74 |
Where Texas sits
The same service costs 4.1 times more in Colorado 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
CO $4,954MT $1,220
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.