How much rates vary
Facilitymedian $178 · 10th to 90th $78 to $2,399Professionalmedian $112 · 10th to 90th $21 to $182
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 $112.20 Median $2,041.74 Typical High $6,760.83 | Facility | None | $112.20 | $2,041.74 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $177.83 | Professional | None | $81.28 | $102.33 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $162.18 | Professional | None | $93.33 | $112.20 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $660.69 | Facility | None | $70.79 | $102.33 | $660.69 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $186.21 | Professional | None | $87.10 | $120.23 | $186.21 |
Baylor Scott & White Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $204.17 | Professional | None | $125.89 | $141.25 | $204.17 |
Christus Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $151.36 | Facility | None | $66.07 | $104.71 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $162.18 | Professional | None | $107.15 | $134.90 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,096.48 | Professional | None | $933.25 | $933.25 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $3,981.07 | Facility | None | $123.03 | $549.54 | $3,981.07 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $186.21 | Professional | None | $81.28 | $112.20 | $186.21 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $89.13 Typical High $138.04 | Professional | None | $16.60 | $89.13 | $138.04 |
Oscar Health Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $851.14 | Facility | None | $457.09 | $851.14 | $851.14 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $165.96 | Facility | None | $66.07 | $112.20 | $165.96 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $162.18 | Professional | None | $109.65 | $134.90 | $162.18 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $83.18 Median $112.20 Typical High $154.88 | Professional | None | $83.18 | $112.20 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
13 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 $39.81 Median $47.86 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $72.44 Typical High $91.20 | Professional | 54 · Surgery only | $60.26 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.45 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $67.61 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $56.23 | $67.61 | $85.11 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $95.50 Median $104.71 Typical High $131.83 | Professional | 59 · Distinct service | $95.50 | $104.71 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $47.86 Typical High $58.88 | Professional | 52 · Reduced service | $39.81 | $47.86 | $58.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $16.22 | $19.50 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $72.44 Typical High $93.33 | Professional | 54 · Surgery only | $60.26 | $72.44 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.45 Typical High $17.78 | Professional | 55 · Aftercare only | $12.02 | $14.45 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.77 Typical High $11.75 | Professional | 56 · Pre-op care only | $8.13 | $9.77 | $11.75 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $67.61 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $56.23 | $67.61 | $85.11 |
Where Texas sits
The same service costs 4.4 times more in Alaska 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.
Texas· 42nd of 51
$115
AK $437KY $100
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.