How much rates vary
Facilitymedian $6,026 · 10th to 90th $2,951 to $12,589Professionalmedian $692 · 10th to 90th $30 to $1,514
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 $1,174.90 Median $3,801.89 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,801.89 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,202.26 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,174.90 | Professional | None | $1,122.02 | $1,122.02 | $1,174.90 |
BCBS Texas Setting Facility Modifier None Typical Low $3,090.30 Median $6,025.60 Typical High $15,488.17 | Facility | None | $3,090.30 | $6,025.60 | $15,488.17 |
BCBS Texas Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,258.93 | $2,041.74 |
Christus Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $4,570.88 Typical High $7,585.78 | Facility | None | $1,778.28 | $4,570.88 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,513.56 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $11,220.18 Typical High $11,220.18 | Professional | None | $10,964.78 | $11,220.18 | $11,220.18 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,073.80 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,230.27 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $181.97 Typical High $1,174.90 | Professional | None | $27.54 | $181.97 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,365.16 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,365.16 | $4,786.30 |
Providence Setting Facility Modifier None Typical Low $1,548.82 Median $4,897.79 Typical High $11,748.98 | Facility | None | $1,548.82 | $4,897.79 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,230.27 | $1,513.56 | $2,089.30 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,318.26 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $537.03 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $954.99 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $602.56 Typical High $676.08 | Professional | 52 · Reduced service | $537.03 | $602.56 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $218.78 | $239.88 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $912.01 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $204.17 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $138.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $954.99 |
Where Texas sits
The same service costs 4.7 times more in Colorado than in Kentucky. 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 $15,002KY $3,224
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.