How much rates vary
Facilitymedian $347 · 10th to 90th $174 to $2,951Professionalmedian $209 · 10th to 90th $33 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 $512.86 Median $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $346.74 | Professional | None | $144.54 | $213.80 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $138.04 | Professional | None | $120.23 | $131.83 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $169.82 Median $251.19 Typical High $1,445.44 | Facility | None | $169.82 | $251.19 | $1,445.44 |
BCBS Texas Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $416.87 | Professional | None | $158.49 | $245.47 | $416.87 |
Baylor Scott & White Setting Professional Modifier None Typical Low $87.10 Median $269.15 Typical High $426.58 | Professional | None | $87.10 | $269.15 | $426.58 |
Christus Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $251.19 Typical High $1,412.54 | Facility | None | $177.83 | $251.19 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $380.19 | Professional | None | $186.21 | $263.03 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $1,479.11 Typical High $5,370.32 | Facility | None | $208.93 | $1,479.11 | $5,370.32 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $363.08 | Professional | None | $144.54 | $213.80 | $363.08 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $151.36 Typical High $257.04 | Professional | None | $29.51 | $151.36 | $257.04 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $3,801.89 | Facility | None | $190.55 | $316.23 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $380.19 | Professional | None | $186.21 | $263.03 | $380.19 |
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 $158.49 Median $229.09 Typical High $354.81 | Professional | None | $158.49 | $229.09 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $72.44 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $72.44 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $28.84 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $109.65 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $72.44 | $107.15 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $28.84 | $42.66 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $109.65 | $162.18 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $21.88 | $32.36 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.45 | $21.38 | $26.30 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $102.33 | $151.36 | $186.21 |
Where Texas sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 51st of 51
$214
AK $776TX $214
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.