How much rates vary
Facilitymedian $8,318 · 10th to 90th $1,622 to $16,982Professionalmedian $339 · 10th to 90th $52 to $1,202
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $1,479.11 | Professional | None | $331.13 | $380.19 | $1,479.11 |
BCBS Texas Setting Facility Modifier None Typical Low $4,168.69 Median $8,709.64 Typical High $16,595.87 | Facility | None | $4,168.69 | $8,709.64 | $16,595.87 |
BCBS Texas Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $707.95 | Professional | None | $371.54 | $478.63 | $707.95 |
Christus Setting Facility Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $16,982.44 | Facility | None | $16,982.44 | $16,982.44 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $10,715.19 Typical High $20,892.96 | Facility | None | $457.09 | $10,715.19 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $660.69 | Professional | None | $407.38 | $467.74 | $660.69 |
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 $3,630.78 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,630.78 | $4,466.84 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,905.46 Typical High $6,025.60 | Facility | None | $426.58 | $1,905.46 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $616.60 | Professional | None | $331.13 | $380.19 | $616.60 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $275.42 Typical High $407.38 | Professional | None | $47.86 | $275.42 | $407.38 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $3,981.07 Typical High $14,454.40 | Facility | None | $426.58 | $3,981.07 | $14,454.40 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $676.08 | Professional | None | $407.38 | $467.74 | $676.08 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,698.24 | $4,570.88 | $10,471.29 |
United Setting Professional Modifier None Typical Low $316.23 Median $416.87 Typical High $645.65 | Professional | None | $316.23 | $416.87 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $165.96 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $165.96 | $181.97 | $208.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $72.44 | $83.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $251.19 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $295.12 |
Where Texas sits
The same service costs 11.7 times more in Wyoming 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
WY $15,432MT $1,323
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.