How much rates vary
Facilitymedian $1,175 · 10th to 90th $513 to $3,715Professionalmedian $214 · 10th to 90th $28 to $398
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 $457.09 Median $2,187.76 Typical High $6,760.83 | Facility | None | $457.09 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $389.05 | Professional | None | $169.82 | $229.09 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $275.42 | Professional | None | $125.89 | $194.98 | $275.42 |
BCBS Texas Setting Facility Modifier None Typical Low $616.60 Median $1,380.38 Typical High $3,801.89 | Facility | None | $616.60 | $1,380.38 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $436.52 | Professional | None | $208.93 | $275.42 | $436.52 |
Christus Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $1,659.59 | Facility | None | $457.09 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | None | $218.78 | $288.40 | $380.19 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,202.26 Typical High $4,365.16 | Facility | None | $234.42 | $1,202.26 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $389.05 | Professional | None | $169.82 | $229.09 | $389.05 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $42.66 Typical High $257.04 | Professional | None | $5.89 | $42.66 | $257.04 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $977.24 Typical High $3,801.89 | Facility | None | $302.00 | $977.24 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $380.19 | Professional | None | $218.78 | $288.40 | $380.19 |
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 $186.21 Median $257.04 Typical High $363.08 | Professional | None | $186.21 | $257.04 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $85.11 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $109.65 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $109.65 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $43.65 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $204.17 | Professional | 54 · Surgery only | $128.82 | $165.96 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $40.74 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $26.92 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $190.55 |
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
$240
AK $912KY $234
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.