How much rates vary
Facilitymedian $479 · 10th to 90th $178 to $2,754Professionalmedian $209 · 10th to 90th $28 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 $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 $158.49 Median $229.09 Typical High $363.08 | Professional | None | $158.49 | $229.09 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $309.03 | Professional | None | $141.25 | $181.97 | $309.03 |
BCBS Texas Setting Facility Modifier None Typical Low $173.78 Median $263.03 Typical High $1,513.56 | Facility | None | $173.78 | $263.03 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
Baylor Scott & White Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $501.19 | Professional | None | $288.40 | $338.84 | $501.19 |
Christus Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $223.87 Typical High $338.84 | Facility | None | $66.07 | $223.87 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $1,000.00 Typical High $4,677.35 | Facility | None | $204.17 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $371.54 | Professional | None | $158.49 | $229.09 | $371.54 |
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 $66.07 Median $234.42 Typical High $398.11 | Facility | None | $66.07 | $234.42 | $398.11 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
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 $173.78 Median $251.19 Typical High $380.19 | Professional | None | $173.78 | $251.19 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $114.82 Typical High $141.25 | Professional | 52 · Reduced service | $79.43 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $31.62 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $42.66 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.91 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.85 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $114.82 Typical High $141.25 | Professional | 52 · Reduced service | $79.43 | $114.82 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $31.62 | $45.71 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $117.49 | $169.82 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $34.67 Typical High $42.66 | Professional | 55 · Aftercare only | $23.44 | $34.67 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.91 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.85 | $22.91 | $28.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $194.98 |
Where Texas sits
The same service costs 3.9 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
$219
AK $851TX $219
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.