How much rates vary
Facilitymedian $1,349 · 10th to 90th $525 to $3,981Professionalmedian $107 · 10th to 90th $17 to $1,230
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $181.97 | Professional | None | $109.65 | $117.49 | $181.97 |
BCBS Texas Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $3,630.78 | Facility | None | $758.58 | $1,380.38 | $3,630.78 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $177.83 | Professional | None | $102.33 | $128.82 | $177.83 |
Christus Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,412.54 | Facility | None | $446.68 | $660.69 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $213.80 | Professional | None | $95.50 | $138.04 | $213.80 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,862.09 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $1,778.28 Typical High $5,248.07 | Facility | None | $117.49 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $158.49 | Professional | None | $109.65 | $117.49 | $158.49 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $371.54 | Professional | None | $162.18 | $363.08 | $371.54 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $724.44 Typical High $3,801.89 | Facility | None | $338.84 | $724.44 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $208.93 | Professional | None | $95.50 | $138.04 | $208.93 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,801.89 | Facility | None | $616.60 | $1,995.26 | $3,801.89 |
United Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $186.21 | Professional | None | $91.20 | $125.89 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
10 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 $54.95 Median $57.54 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $21.88 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $83.18 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $14.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $54.95 | $57.54 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $21.88 | $23.44 | $25.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $83.18 | $87.10 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $12.88 |
Where Texas sits
The same service costs 11.4 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 $4,049MT $356
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.