How much rates vary
Facilitymedian $398 · 10th to 90th $151 to $2,884Professionalmedian $195 · 10th to 90th $35 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 $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 $112.20 Median $177.83 Typical High $263.03 | Professional | None | $112.20 | $177.83 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $1,288.25 | Facility | None | $144.54 | $218.78 | $1,288.25 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $338.84 | Professional | None | $138.04 | $218.78 | $338.84 |
Christus Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $1,412.54 | Facility | None | $154.88 | $218.78 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $144.54 Median $1,000.00 Typical High $4,677.35 | Facility | None | $144.54 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $288.40 | Professional | None | $112.20 | $177.83 | $288.40 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $173.78 Typical High $245.47 | Professional | None | $32.36 | $173.78 | $245.47 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $288.40 Typical High $3,801.89 | Facility | None | $162.18 | $288.40 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $309.03 | Professional | None | $144.54 | $213.80 | $309.03 |
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 $123.03 Median $190.55 Typical High $288.40 | Professional | None | $123.03 | $190.55 | $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 $56.23 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $22.39 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $85.11 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $123.03 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $79.43 | $123.03 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $87.10 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $34.67 Typical High $43.65 | Professional | 53 · Discontinued | $22.39 | $34.67 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $85.11 | $131.83 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $26.30 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.22 | $17.38 | $21.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $123.03 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $79.43 | $123.03 | $154.88 |
Where Texas sits
The same service costs 3.4 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· 43rd of 51
$204
AK $603KY $178
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.