How much rates vary
Facilitymedian $263 · 10th to 90th $135 to $3,311Professionalmedian $148 · 10th to 90th $26 to $269
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $275.42 | Professional | None | $93.33 | $154.88 | $275.42 |
BCBS Texas Setting Facility Modifier None Typical Low $128.82 Median $194.98 Typical High $1,202.26 | Facility | None | $128.82 | $194.98 | $1,202.26 |
BCBS Texas Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $295.12 | Professional | None | $112.20 | $181.97 | $295.12 |
Christus Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $199.53 Typical High $1,412.54 | Facility | None | $141.25 | $199.53 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $269.15 | Professional | None | $117.49 | $181.97 | $269.15 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,412.54 | $1,412.54 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $1,000.00 Typical High $4,570.88 | Facility | None | $114.82 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $275.42 | Professional | None | $93.33 | $154.88 | $275.42 |
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 $147.91 Median $251.19 Typical High $3,801.89 | Facility | None | $147.91 | $251.19 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $269.15 | Professional | None | $117.49 | $186.21 | $269.15 |
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 $100.00 Median $158.49 Typical High $245.47 | Professional | None | $100.00 | $158.49 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $46.77 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $46.77 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $18.62 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $69.18 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $14.13 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.33 | $15.14 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $104.71 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $64.57 | $104.71 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $46.77 | $75.86 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $30.20 Typical High $38.02 | Professional | 53 · Discontinued | $18.62 | $30.20 | $38.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $112.20 Typical High $141.25 | Professional | 54 · Surgery only | $69.18 | $112.20 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.39 Typical High $28.18 | Professional | 55 · Aftercare only | $14.13 | $22.39 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.14 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.33 | $15.14 | $19.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $104.71 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $64.57 | $104.71 | $131.83 |
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· 48th of 51
$158
AK $501KY $138
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.