How much rates vary
Facilitymedian $1,047 · 10th to 90th $407 to $3,090Professionalmedian $182 · 10th to 90th $31 to $309
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $251.19 | Professional | None | $151.36 | $181.97 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | None | $162.18 | $162.18 | $218.78 |
BCBS Texas Setting Facility Modifier None Typical Low $457.09 Median $891.25 Typical High $2,344.23 | Facility | None | $457.09 | $891.25 | $2,344.23 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $630.96 | Professional | None | $162.18 | $223.87 | $630.96 |
Christus Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $1,412.54 | Facility | None | $436.52 | $630.96 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $309.03 | Professional | None | $177.83 | $229.09 | $309.03 |
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 $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $1,000.00 Typical High $4,570.88 | Facility | None | $177.83 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | None | $151.36 | $181.97 | $257.04 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $162.18 Typical High $234.42 | Professional | None | $28.84 | $162.18 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $851.14 | Professional | None | $602.56 | $630.96 | $851.14 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $660.69 Typical High $3,801.89 | Facility | None | $251.19 | $660.69 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $309.03 | Professional | None | $177.83 | $229.09 | $309.03 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,090.30 | Facility | None | $389.05 | $1,288.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $302.00 | Professional | None | $141.25 | $194.98 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $75.86 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $75.86 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $30.20 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $165.96 | Professional | 54 · Surgery only | $114.82 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $33.11 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $15.14 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $75.86 | $91.20 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $30.20 | $36.31 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $114.82 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $22.91 | $27.54 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $15.14 | $18.20 | $20.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $128.82 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $107.15 | $128.82 | $147.91 |
Where Texas sits
The same service costs 4.9 times more in New York than in North Dakota. 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
NY $2,949ND $598
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.