How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,175 to $5,888Professionalmedian $275 · 10th to 90th $51 to $794
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $407.38 | Professional | None | $218.78 | $275.42 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $288.40 | Professional | None | $107.15 | $204.17 | $288.40 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $2,630.27 Typical High $6,309.57 | Facility | None | $1,258.93 | $2,630.27 | $6,309.57 |
BCBS Texas Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $467.74 | Professional | None | $190.55 | $275.42 | $467.74 |
Christus Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $2,818.38 | Facility | None | $588.84 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $436.52 | Professional | None | $234.42 | $302.00 | $436.52 |
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 $2,137.96 Median $2,137.96 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,137.96 | $2,570.40 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $2,630.27 Typical High $5,623.41 | Facility | None | $288.40 | $2,630.27 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $426.58 | Professional | None | $218.78 | $281.84 | $426.58 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $229.09 Typical High $338.84 | Professional | None | $42.66 | $229.09 | $338.84 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $2,089.30 Typical High $4,466.84 | Facility | None | $338.84 | $2,089.30 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $436.52 | Professional | None | $234.42 | $302.00 | $436.52 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $389.05 | Professional | None | $190.55 | $257.04 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $109.65 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $109.65 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $43.65 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $162.18 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $151.36 | $190.55 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $138.04 Typical High $177.83 | Professional | 52 · Reduced service | $109.65 | $138.04 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $70.79 | Professional | 53 · Discontinued | $43.65 | $54.95 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $263.03 | Professional | 54 · Surgery only | $162.18 | $204.17 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $35.48 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $35.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $190.55 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $151.36 | $190.55 | $245.47 |
Where Texas sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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 $5,029WV $590
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.