How much rates vary
Facilitymedian $1,660 · 10th to 90th $525 to $4,266Professionalmedian $132 · 10th to 90th $29 to $1,023
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $199.53 | Professional | None | $102.33 | $144.54 | $199.53 |
BCBS Texas Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $4,466.84 | Facility | None | $933.25 | $1,778.28 | $4,466.84 |
BCBS Texas Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $177.83 | Professional | None | $93.33 | $128.82 | $177.83 |
Christus Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $2,187.76 | Facility | None | $602.56 | $1,380.38 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $194.98 | Professional | None | $95.50 | $131.83 | $194.98 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,023.29 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $1,122.02 Typical High $4,786.30 | Facility | None | $109.65 | $1,122.02 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $199.53 | Professional | None | $102.33 | $144.54 | $199.53 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $107.15 Typical High $147.91 | Professional | None | $19.95 | $107.15 | $147.91 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $1,445.44 Typical High $4,466.84 | Facility | None | $154.88 | $1,445.44 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $194.98 | Professional | None | $95.50 | $131.83 | $194.98 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $181.97 | Professional | None | $85.11 | $123.03 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | None | $138.04 | $144.54 | $144.54 |
10 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 $50.12 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $50.12 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $75.86 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $14.45 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $50.12 | $72.44 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $28.84 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $107.15 Typical High $134.90 | Professional | 54 · Surgery only | $75.86 | $107.15 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $14.45 | $17.78 |
Where Texas sits
The same service costs 10.9 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 $3,950MT $363
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.