How much rates vary
Facilitymedian $1,175 · 10th to 90th $617 to $3,981Professionalmedian $263 · 10th to 90th $38 to $437
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 $177.83 Median $263.03 Typical High $467.74 | Professional | None | $177.83 | $263.03 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $3,801.89 | Facility | None | $691.83 | $1,445.44 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $501.19 | Professional | None | $218.78 | $323.59 | $501.19 |
Christus Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | None | $229.09 | $316.23 | $457.09 |
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 $2,454.71 Median $2,454.71 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,454.71 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $1,174.90 Typical High $4,786.30 | Facility | None | $239.88 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $457.09 | Professional | None | $177.83 | $263.03 | $457.09 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $204.17 Typical High $331.13 | Professional | None | $32.36 | $204.17 | $331.13 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $1,000.00 Typical High $4,466.84 | Facility | None | $346.74 | $1,000.00 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | None | $229.09 | $316.23 | $457.09 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $426.58 | Professional | None | $199.53 | $281.84 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $89.13 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $134.90 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $125.89 | $181.97 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $128.82 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $52.48 Typical High $64.57 | Professional | 53 · Discontinued | $35.48 | $52.48 | $64.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $194.98 Typical High $239.88 | Professional | 54 · Surgery only | $134.90 | $194.98 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $38.90 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $38.90 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.30 Typical High $32.36 | Professional | 56 · Pre-op care only | $17.78 | $26.30 | $32.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $181.97 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $125.89 | $181.97 | $223.87 |
Where Texas sits
The same service costs 4.0 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
$282
AK $1,072KY $269
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.