How much rates vary
Facilitymedian $6,918 · 10th to 90th $2,570 to $17,783Professionalmedian $589 · 10th to 90th $23 to $1,549
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 $1,288.25 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,288.25 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,122.02 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,445.44 | $1,737.80 |
BCBS Texas Setting Facility Modifier None Typical Low $3,801.89 Median $8,128.31 Typical High $21,877.62 | Facility | None | $3,801.89 | $8,128.31 | $21,877.62 |
BCBS Texas Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,995.26 | Professional | None | $812.83 | $1,000.00 | $1,995.26 |
Christus Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,309.57 Typical High $8,317.64 | Facility | None | $1,737.80 | $6,309.57 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,258.93 | $1,905.46 |
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 $7,943.28 Median $7,943.28 Typical High $8,511.38 | Professional | None | $7,943.28 | $7,943.28 | $8,511.38 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $5,754.40 Typical High $16,218.10 | Facility | None | $1,148.15 | $5,754.40 | $16,218.10 |
Moda Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,122.02 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $141.25 Typical High $891.25 | Professional | None | $19.95 | $141.25 | $891.25 |
Providence Setting Facility Modifier None Typical Low $1,479.11 Median $6,606.93 Typical High $11,748.98 | Facility | None | $1,479.11 | $6,606.93 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,258.93 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,456.54 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,456.54 | $15,848.93 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,778.28 | Professional | None | $870.96 | $1,174.90 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $501.19 Median $549.54 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $218.78 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $223.87 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $831.76 | $977.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $912.01 |
Where Texas sits
The same service costs 4.8 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 $16,076MT $3,358
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.