How much rates vary
Facilitymedian $676 · 10th to 90th $380 to $3,090Professionalmedian $234 · 10th to 90th $35 to $389
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 $645.65 Median $2,630.27 Typical High $6,918.31 | Facility | None | $645.65 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $398.11 | Professional | None | $158.49 | $239.88 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $302.00 | Professional | None | $158.49 | $158.49 | $302.00 |
BCBS Texas Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $1,949.84 | Facility | None | $371.54 | $724.44 | $1,949.84 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $478.63 | Professional | None | $194.98 | $295.12 | $478.63 |
Baylor Scott & White Setting Facility Modifier None Typical Low $204.17 Median $758.58 Typical High $3,890.45 | Facility | None | $204.17 | $758.58 | $3,890.45 |
Christus Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $1,862.09 | Facility | None | $380.19 | $524.81 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $416.87 | Professional | None | $204.17 | $295.12 | $416.87 |
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 $2,238.72 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,238.72 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $1,174.90 Typical High $5,495.41 | Facility | None | $229.09 | $1,174.90 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $416.87 | Professional | None | $158.49 | $239.88 | $416.87 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $177.83 Typical High $295.12 | Professional | None | $31.62 | $177.83 | $295.12 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $588.84 Typical High $4,466.84 | Facility | None | $309.03 | $588.84 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $416.87 | Professional | None | $204.17 | $295.12 | $416.87 |
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 $177.83 Median $257.04 Typical High $389.05 | Professional | None | $177.83 | $257.04 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $79.43 Median $120.23 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $58.88 | Professional | 53 · Discontinued | $32.36 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $120.23 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.99 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $112.20 | $169.82 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $120.23 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $120.23 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $58.88 | Professional | 53 · Discontinued | $32.36 | $47.86 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $120.23 | $181.97 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $44.67 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $44.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $23.99 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $23.99 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $169.82 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $112.20 | $169.82 | $208.93 |
Where Texas sits
The same service costs 3.6 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
$251
AK $851KY $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.