How much rates vary
Facilitymedian $490 · 10th to 90th $132 to $2,291Professionalmedian $148 · 10th to 90th $28 to $282
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 $380.19 Median $2,187.76 Typical High $6,760.83 | Facility | None | $380.19 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $257.04 | Professional | None | $79.43 | $138.04 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $100.00 | Professional | None | $45.71 | $91.20 | $100.00 |
BCBS Texas Setting Facility Modifier None Typical Low $141.25 Median $562.34 Typical High $1,862.09 | Facility | None | $141.25 | $562.34 | $1,862.09 |
BCBS Texas Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $281.84 | Professional | None | $100.00 | $169.82 | $281.84 |
Christus Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $154.88 Typical High $223.87 | Facility | None | $66.07 | $154.88 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $186.21 Typical High $263.03 | Professional | None | $114.82 | $186.21 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $891.25 Typical High $4,570.88 | Facility | None | $147.91 | $891.25 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $257.04 | Professional | None | $79.43 | $138.04 | $257.04 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $204.17 | Professional | None | $21.88 | $117.49 | $204.17 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $158.49 Typical High $239.88 | Facility | None | $66.07 | $158.49 | $239.88 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $263.03 | Professional | None | $120.23 | $186.21 | $263.03 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $251.19 | Professional | None | $100.00 | $158.49 | $251.19 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $39.81 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $39.81 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $15.85 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $102.33 Typical High $125.89 | Professional | 54 · Surgery only | $60.26 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $12.02 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $13.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.94 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $95.50 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $56.23 | $95.50 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $39.81 | $67.61 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $26.92 Typical High $33.88 | Professional | 53 · Discontinued | $15.85 | $26.92 | $33.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $102.33 Typical High $125.89 | Professional | 54 · Surgery only | $60.26 | $102.33 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $12.02 | $20.42 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $13.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.94 | $13.49 | $16.98 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $95.50 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $56.23 | $95.50 | $117.49 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Florida. 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 $490FL $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.