How much rates vary
Facilitymedian $575 · 10th to 90th $126 to $3,548Professionalmedian $174 · 10th to 90th $30 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 $426.58 Median $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $281.84 | Professional | None | $117.49 | $165.96 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $138.04 | Professional | None | $85.11 | $125.89 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $117.49 Median $177.83 Typical High $1,096.48 | Facility | None | $117.49 | $177.83 | $1,096.48 |
BCBS Texas Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $316.23 | Professional | None | $147.91 | $199.53 | $316.23 |
Christus Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $1,412.54 | Facility | None | $134.90 | $190.55 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $275.42 | Professional | None | $151.36 | $208.93 | $275.42 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,479.11 | $1,479.11 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $1,905.46 Typical High $6,918.31 | Facility | None | $169.82 | $1,905.46 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $281.84 | Professional | None | $117.49 | $165.96 | $281.84 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $147.91 Typical High $208.93 | Professional | None | $27.54 | $147.91 | $208.93 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $251.19 Typical High $3,801.89 | Facility | None | $147.91 | $251.19 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $275.42 | Professional | None | $151.36 | $208.93 | $275.42 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $263.03 | Professional | None | $128.82 | $177.83 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $58.88 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $58.88 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $23.44 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $89.13 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.75 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $112.20 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $83.18 | $112.20 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $58.88 | $79.43 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $23.44 | $31.62 | $38.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $89.13 | $120.23 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $11.75 | $15.85 | $19.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $112.20 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $83.18 | $112.20 | $138.04 |
Where Texas sits
The same service costs 4.0 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· 48th of 51
$182
AK $646KY $162
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.