How much rates vary
Facilitymedian $15,136 · 10th to 90th $1,230 to $33,884Professionalmedian $209 · 10th to 90th $32 to $437
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $398.11 | Professional | None | $269.15 | $302.00 | $398.11 |
BCBS Texas Setting Facility Modifier None Typical Low $13,182.57 Median $21,379.62 Typical High $41,686.94 | Facility | None | $13,182.57 | $21,379.62 | $41,686.94 |
BCBS Texas Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $501.19 | Professional | None | $295.12 | $363.08 | $501.19 |
Christus Setting Facility Modifier None Typical Low $16,595.87 Median $16,595.87 Typical High $16,595.87 | Facility | None | $16,595.87 | $16,595.87 | $16,595.87 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $16,595.87 Typical High $28,840.32 | Facility | None | $457.09 | $16,595.87 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $478.63 | Professional | None | $295.12 | $371.54 | $478.63 |
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 $2,754.23 Median $8,317.64 Typical High $8,317.64 | Professional | None | $2,754.23 | $8,317.64 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $1,778.28 Typical High $5,248.07 | Facility | None | $316.23 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $407.38 | Professional | None | $269.15 | $302.00 | $407.38 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $69.18 Typical High $295.12 | Professional | None | $12.59 | $69.18 | $295.12 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $3,981.07 Typical High $22,908.68 | Facility | None | $407.38 | $3,981.07 | $22,908.68 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $478.63 | Professional | None | $295.12 | $363.08 | $478.63 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $9,772.37 Typical High $33,884.42 | Facility | None | $3,981.07 | $9,772.37 | $33,884.42 |
United Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $446.68 | Professional | None | $245.47 | $309.03 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $134.90 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $134.90 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $53.70 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $199.53 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $134.90 | $147.91 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $53.70 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $199.53 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $186.21 | $208.93 | $234.42 |
Where Texas sits
The same service costs 29.1 times more in Alabama 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
AL $30,626MT $1,051
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.