How much rates vary
Facilitymedian $263 · 10th to 90th $105 to $2,399Professionalmedian $132 · 10th to 90th $28 to $251
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 $134.90 Median $2,089.30 Typical High $6,760.83 | Facility | None | $134.90 | $2,089.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $208.93 | Professional | None | $79.43 | $117.49 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $151.36 Typical High $177.83 | Professional | None | $102.33 | $151.36 | $177.83 |
BCBS Texas Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $977.24 | Facility | None | $100.00 | $154.88 | $977.24 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $223.87 | Professional | None | $87.10 | $134.90 | $223.87 |
Christus Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $199.53 | Facility | None | $66.07 | $138.04 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $204.17 | Professional | None | $112.20 | $151.36 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,096.48 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $616.60 Typical High $3,981.07 | Facility | None | $114.82 | $616.60 | $3,981.07 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $213.80 | Professional | None | $79.43 | $117.49 | $213.80 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $147.91 | Professional | None | $19.50 | $107.15 | $147.91 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $199.53 | Facility | None | $66.07 | $141.25 | $199.53 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $204.17 | Professional | None | $112.20 | $154.88 | $204.17 |
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 $85.11 Median $123.03 Typical High $186.21 | Professional | None | $85.11 | $123.03 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $39.81 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $15.85 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $58.88 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $12.02 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.94 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $81.28 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $54.95 | $81.28 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $39.81 | $58.88 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $15.85 | $23.44 | $28.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $58.88 | $87.10 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.94 | $11.75 | $14.45 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $81.28 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $54.95 | $81.28 | $100.00 |
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· 41st of 51
$138
AK $447KY $110
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.