How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,318 to $7,079Professionalmedian $603 · 10th to 90th $60 to $1,047
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,174.90 | Professional | None | $870.96 | $933.25 | $1,174.90 |
BCBS Texas Setting Facility Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $6,456.54 | Facility | None | $1,380.38 | $2,754.23 | $6,456.54 |
BCBS Texas Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,348.96 | Professional | None | $831.76 | $1,047.13 | $1,348.96 |
Christus Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $2,691.53 | Facility | None | $691.83 | $1,819.70 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,380.38 | Professional | None | $741.31 | $1,096.48 | $1,380.38 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $2,511.89 Typical High $8,511.38 | Facility | None | $812.83 | $2,511.89 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,122.02 | Professional | None | $870.96 | $933.25 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $812.83 | Professional | None | $56.23 | $151.36 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $831.76 | Professional | None | $794.33 | $794.33 | $831.76 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,862.09 Typical High $6,165.95 | Facility | None | $758.58 | $1,862.09 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,348.96 | Professional | None | $741.31 | $1,096.48 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $1,348.96 | Professional | None | $707.95 | $933.25 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $436.52 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $776.25 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | 59 · Distinct service | $851.14 | $851.14 | $851.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $467.74 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $186.21 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $707.95 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $93.33 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $707.95 |
Where Texas sits
The same service costs 2.8 times more in Alaska 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
AK $7,236MD $2,555
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.