How much rates vary
Facilitymedian $245 · 10th to 90th $126 to $2,884Professionalmedian $155 · 10th to 90th $27 to $263
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 $112.20 Median $151.36 Typical High $263.03 | Professional | None | $112.20 | $151.36 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $194.98 | Professional | None | $75.86 | $93.33 | $194.98 |
BCBS Texas Setting Facility Modifier None Typical Low $117.49 Median $177.83 Typical High $1,047.13 | Facility | None | $117.49 | $177.83 | $1,047.13 |
BCBS Texas Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $295.12 | Professional | None | $134.90 | $186.21 | $295.12 |
Baylor Scott & White Setting Facility Modifier None Typical Low $104.71 Median $245.47 Typical High $2,570.40 | Facility | None | $104.71 | $245.47 | $2,570.40 |
Christus Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $1,412.54 | Facility | None | $131.83 | $186.21 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $257.04 | Professional | None | $141.25 | $190.55 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $1,202.26 Typical High $5,495.41 | Facility | None | $151.36 | $1,202.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $263.03 | Professional | None | $112.20 | $154.88 | $263.03 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $125.89 Typical High $194.98 | Professional | None | $22.91 | $125.89 | $194.98 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $245.47 Typical High $3,801.89 | Facility | None | $141.25 | $245.47 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $257.04 | Professional | None | $141.25 | $194.98 | $257.04 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,090.30 | Facility | None | $389.05 | $1,230.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $245.47 | Professional | None | $120.23 | $165.96 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $54.95 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $104.71 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $77.62 | $104.71 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $54.95 | $75.86 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $30.20 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $112.20 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $22.39 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $18.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $104.71 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $77.62 | $104.71 | $128.82 |
Where Texas sits
The same service costs 3.9 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· 49th of 51
$162
AK $603KY $155
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.