How much rates vary
Facilitymedian $1,230 · 10th to 90th $617 to $3,981Professionalmedian $204 · 10th to 90th $35 to $347
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $316.23 | Professional | None | $134.90 | $181.97 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $239.88 | Professional | None | $117.49 | $169.82 | $239.88 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,479.11 Typical High $3,981.07 | Facility | None | $691.83 | $1,479.11 | $3,981.07 |
BCBS Texas Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $354.81 | Professional | None | $169.82 | $229.09 | $354.81 |
Christus Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $316.23 | Professional | None | $177.83 | $239.88 | $316.23 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,737.80 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $1,905.46 Typical High $5,011.87 | Facility | None | $194.98 | $1,905.46 | $5,011.87 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $181.97 Typical High $316.23 | Professional | None | $134.90 | $181.97 | $316.23 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $173.78 Typical High $245.47 | Professional | None | $32.36 | $173.78 | $245.47 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $1,000.00 Typical High $4,466.84 | Facility | None | $245.47 | $1,000.00 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $316.23 | Professional | None | $177.83 | $239.88 | $316.23 |
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 $147.91 Median $204.17 Typical High $302.00 | Professional | None | $147.91 | $204.17 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $67.61 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $67.61 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $26.92 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $100.00 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.49 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $93.33 | $125.89 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $67.61 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $26.92 | $36.31 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $100.00 | $134.90 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $19.95 | $27.54 | $33.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.49 | $18.20 | $22.39 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $125.89 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $93.33 | $125.89 | $154.88 |
Where Texas sits
The same service costs 4.7 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· 43rd of 51
$224
AK $871KY $186
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.