How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,291 to $12,023Professionalmedian $417 · 10th to 90th $62 to $708
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 $1,202.26 Median $4,168.69 Typical High $10,000.00 | Facility | None | $1,202.26 | $4,168.69 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $831.76 | Professional | None | $549.54 | $588.84 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
BCBS Texas Setting Facility Modifier None Typical Low $2,454.71 Median $4,897.79 Typical High $12,589.25 | Facility | None | $2,454.71 | $4,897.79 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $912.01 | Professional | None | $446.68 | $537.03 | $912.01 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $6,760.83 | Facility | None | $1,737.80 | $3,890.45 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $851.14 | Professional | None | $489.78 | $691.83 | $851.14 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,897.79 | Professional | None | $4,786.30 | $4,786.30 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $3,981.07 Typical High $11,748.98 | Facility | None | $660.69 | $3,981.07 | $11,748.98 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $831.76 | Professional | None | $549.54 | $588.84 | $831.76 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $537.03 | Professional | None | $54.95 | $100.00 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $616.60 | Professional | None | $588.84 | $588.84 | $616.60 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $4,073.80 Typical High $11,748.98 | Facility | None | $870.96 | $4,073.80 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $851.14 | Professional | None | $478.63 | $707.95 | $851.14 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,456.54 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,456.54 | $14,791.08 |
United Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $851.14 | Professional | None | $446.68 | $588.84 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
13 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 $275.42 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $275.42 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $109.65 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $416.87 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $478.63 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | GC · Resident with teaching physician | $549.54 | $549.54 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 52 · Reduced service | $275.42 | $295.12 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $120.23 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $478.63 | Professional | 54 · Surgery only | $416.87 | $446.68 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $95.50 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $60.26 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $60.26 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $446.68 |
Where Texas sits
The same service costs 5.8 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 $11,009MT $1,889
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.