How much rates vary
Facilitymedian $380 · 10th to 90th $138 to $3,090Professionalmedian $182 · 10th to 90th $30 to $339
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $309.03 | Professional | None | $134.90 | $186.21 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $154.88 | Professional | None | $93.33 | $109.65 | $154.88 |
BCBS Texas Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $1,148.15 | Facility | None | $128.82 | $194.98 | $1,148.15 |
BCBS Texas Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $346.74 | Professional | None | $165.96 | $223.87 | $346.74 |
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 $147.91 Median $204.17 Typical High $1,412.54 | Facility | None | $147.91 | $204.17 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $302.00 | Professional | None | $173.78 | $229.09 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $1,698.24 Typical High $5,248.07 | Facility | None | $186.21 | $1,698.24 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $316.23 | Professional | None | $134.90 | $190.55 | $316.23 |
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 $162.18 Median $269.15 Typical High $3,801.89 | Facility | None | $162.18 | $269.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $302.00 | Professional | None | $173.78 | $229.09 | $302.00 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $288.40 | Professional | None | $147.91 | $204.17 | $288.40 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $102.33 | $131.83 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $123.03 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $95.50 | $123.03 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $89.13 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $35.48 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $131.83 Typical High $162.18 | Professional | 54 · Surgery only | $102.33 | $131.83 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $26.30 Typical High $32.36 | Professional | 55 · Aftercare only | $20.42 | $26.30 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $123.03 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $95.50 | $123.03 | $151.36 |
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· 50th of 51
$191
AK $724KY $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.