How much rates vary
Facilitymedian $427 · 10th to 90th $141 to $2,630Professionalmedian $170 · 10th to 90th $32 to $302
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 $398.11 Median $2,187.76 Typical High $6,760.83 | Facility | None | $398.11 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $338.84 | Professional | None | $79.43 | $169.82 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $331.13 | Professional | None | $102.33 | $169.82 | $331.13 |
BCBS Texas Setting Facility Modifier None Typical Low $131.83 Median $223.87 Typical High $1,318.26 | Facility | None | $131.83 | $223.87 | $1,318.26 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $309.03 | Professional | None | $87.10 | $186.21 | $309.03 |
Christus Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $269.15 Typical High $380.19 | Facility | None | $66.07 | $269.15 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $309.03 | Professional | None | $112.20 | $186.21 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,778.28 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $691.83 Typical High $4,265.80 | Facility | None | $147.91 | $691.83 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $338.84 | Professional | None | $79.43 | $169.82 | $338.84 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $54.95 Typical High $257.04 | Professional | None | $28.84 | $54.95 | $257.04 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $263.03 Typical High $371.54 | Facility | None | $66.07 | $263.03 | $371.54 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $190.55 Typical High $309.03 | Professional | None | $112.20 | $190.55 | $309.03 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $251.19 | Professional | None | $85.11 | $147.91 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $39.81 Median $87.10 Typical High $123.03 | Professional | 52 · Reduced service | $39.81 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $34.67 Typical High $48.98 | Professional | 53 · Discontinued | $15.85 | $34.67 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $128.82 Typical High $186.21 | Professional | 54 · Surgery only | $60.26 | $128.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $25.70 Typical High $37.15 | Professional | 55 · Aftercare only | $12.02 | $25.70 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $7.94 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $120.23 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $56.23 | $120.23 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $91.20 Typical High $123.03 | Professional | 52 · Reduced service | $39.81 | $91.20 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $34.67 Typical High $48.98 | Professional | 53 · Discontinued | $15.85 | $34.67 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $128.82 Typical High $186.21 | Professional | 54 · Surgery only | $60.26 | $128.82 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $25.70 Typical High $37.15 | Professional | 55 · Aftercare only | $12.02 | $25.70 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $17.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $7.94 | $17.38 | $24.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $120.23 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $56.23 | $120.23 | $173.78 |
Where Texas sits
The same service costs 4.1 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· 40th of 51
$186
AK $501KY $123
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.