How much rates vary
Facilitymedian $251 · 10th to 90th $120 to $2,512Professionalmedian $182 · 10th to 90th $31 to $316
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 $194.98 Median $2,089.30 Typical High $6,760.83 | Facility | None | $194.98 | $2,089.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $302.00 | Professional | None | $138.04 | $177.83 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $302.00 | Professional | None | $151.36 | $194.98 | $302.00 |
BCBS Texas Setting Facility Modifier None Typical Low $109.65 Median $154.88 Typical High $933.25 | Facility | None | $109.65 | $154.88 | $933.25 |
BCBS Texas Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $323.59 | Professional | None | $151.36 | $204.17 | $323.59 |
Baylor Scott & White Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $338.84 | Professional | None | $169.82 | $169.82 | $338.84 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $1,412.54 | Facility | None | $128.82 | $186.21 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $281.84 | Professional | None | $190.55 | $234.42 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,548.82 | $1,905.46 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $891.25 Typical High $5,495.41 | Facility | None | $190.55 | $891.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $302.00 | Professional | None | $138.04 | $186.21 | $302.00 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $147.91 Typical High $208.93 | Professional | None | $27.54 | $147.91 | $208.93 |
Oscar Health Setting Facility Modifier None Typical Low $457.09 Median $4,265.80 Typical High $4,265.80 | Facility | None | $457.09 | $4,265.80 | $4,265.80 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $251.19 Typical High $3,801.89 | Facility | None | $151.36 | $251.19 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $281.84 | Professional | None | $190.55 | $239.88 | $281.84 |
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 $151.36 Median $199.53 Typical High $269.15 | Professional | None | $151.36 | $199.53 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $69.18 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $69.18 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $41.69 | Professional | 53 · Discontinued | $28.18 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $154.88 | Professional | 54 · Surgery only | $104.71 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $30.90 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.80 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $69.18 | $83.18 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $28.18 | $33.11 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $154.88 | Professional | 54 · Surgery only | $104.71 | $123.03 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $13.80 | $16.60 | $20.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $114.82 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $97.72 | $114.82 | $144.54 |
Where Texas sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 48th of 51
$186
AK $759FL $174
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.