How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,445 to $7,079Professionalmedian $525 · 10th to 90th $78 to $1,660
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 $2,630.27 Typical High $6,918.31 | Facility | None | $851.14 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $794.33 Typical High $1,071.52 | Professional | None | $181.97 | $794.33 | $1,071.52 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $162.18 Typical High $707.95 | Professional | None | $74.13 | $162.18 | $707.95 |
BCBS Texas Setting Facility Modifier None Typical Low $1,513.56 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,513.56 | $3,162.28 | $7,762.47 |
BCBS Texas Setting Professional Modifier None Typical Low $147.91 Median $537.03 Typical High $1,047.13 | Professional | None | $147.91 | $537.03 | $1,047.13 |
Baylor Scott & White Setting Facility Modifier None Typical Low $549.54 Median $3,388.44 Typical High $7,585.78 | Facility | None | $549.54 | $3,388.44 | $7,585.78 |
Christus Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,570.40 Typical High $3,715.35 | Facility | None | $630.96 | $2,570.40 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $446.68 Typical High $1,096.48 | Professional | None | $190.55 | $446.68 | $1,096.48 |
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 $5,248.07 Median $5,248.07 Typical High $6,606.93 | Professional | None | $5,248.07 | $5,248.07 | $6,606.93 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $2,290.87 Typical High $5,248.07 | Facility | None | $288.40 | $2,290.87 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $794.33 Typical High $1,047.13 | Professional | None | $181.97 | $794.33 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $128.82 Typical High $724.44 | Professional | None | $54.95 | $128.82 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $630.96 Typical High $1,584.89 | Professional | None | $177.83 | $630.96 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $2,454.71 Typical High $4,466.84 | Facility | None | $537.03 | $2,454.71 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $1,096.48 | Professional | None | $190.55 | $478.63 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $4,570.88 Typical High $9,332.54 | Facility | None | $1,737.80 | $4,570.88 | $9,332.54 |
United Setting Professional Modifier None Typical Low $162.18 Median $537.03 Typical High $1,148.15 | Professional | None | $162.18 | $537.03 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $91.20 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $91.20 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $36.31 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $138.04 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $27.54 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $18.20 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $128.82 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $91.20 | $398.11 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $36.31 | $162.18 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $138.04 | $602.56 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $27.54 | $120.23 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $18.20 | $79.43 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $128.82 | $562.34 | $645.65 |
Where Texas sits
The same service costs 5.1 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 $7,315MT $1,443
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.