How much rates vary
Facilitymedian $2,138 · 10th to 90th $603 to $10,715Professionalmedian $741 · 10th to 90th $17 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 $1,071.52 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,122.02 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,071.52 | $1,258.93 |
BCBS Texas Setting Facility Modifier None Typical Low $1,174.90 Median $2,238.72 Typical High $12,882.50 | Facility | None | $1,174.90 | $2,238.72 | $12,882.50 |
BCBS Texas Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,318.26 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,412.54 | $1,949.84 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $16,595.87 Typical High $16,595.87 | Professional | None | $12,022.64 | $16,595.87 | $16,595.87 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $6,025.60 | Facility | None | $1,000.00 | $2,137.96 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,122.02 | $1,621.81 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $154.88 Typical High $1,023.29 | Professional | None | $15.14 | $154.88 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $1,513.56 Typical High $251,188.64 | Facility | None | $794.33 | $1,513.56 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,412.54 | $1,949.84 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $1,862.09 | Professional | None | $891.25 | $1,230.27 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $537.03 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $223.87 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $549.54 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $223.87 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $223.87 | $239.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $891.25 | Professional | 54 · Surgery only | $812.83 | $831.76 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $120.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $831.76 |
Where Texas sits
The same service costs 15.0 times more in Maine 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
ME $27,816MD $1,851
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.