How much rates vary
Facilitymedian $380 · 10th to 90th $170 to $3,388Professionalmedian $209 · 10th to 90th $32 to $355
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 $676.08 Median $2,570.40 Typical High $6,918.31 | Facility | None | $676.08 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $295.12 | Professional | None | $134.90 | $213.80 | $295.12 |
BCBS Texas Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $1,584.89 | Facility | None | $169.82 | $257.04 | $1,584.89 |
BCBS Texas Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $912.01 | Professional | None | $154.88 | $263.03 | $912.01 |
Christus Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $229.09 Typical High $331.13 | Facility | None | $66.07 | $229.09 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $398.11 | Professional | None | $199.53 | $288.40 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,089.30 | $2,511.89 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $1,096.48 Typical High $4,786.30 | Facility | None | $199.53 | $1,096.48 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $213.80 Typical High $323.59 | Professional | None | $134.90 | $213.80 | $323.59 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $151.36 Typical High $295.12 | Professional | None | $29.51 | $151.36 | $295.12 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $239.88 Typical High $354.81 | Facility | None | $66.07 | $239.88 | $354.81 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $398.11 | Professional | None | $199.53 | $295.12 | $398.11 |
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 $158.49 Median $245.47 Typical High $363.08 | Professional | None | $158.49 | $245.47 | $363.08 |
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 $67.61 Median $104.71 Typical High $131.83 | Professional | 52 · Reduced service | $67.61 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $26.92 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $102.33 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $20.42 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $20.89 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.49 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $147.91 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $95.50 | $147.91 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $67.61 | $107.15 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $26.92 | $42.66 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $162.18 Typical High $190.55 | Professional | 54 · Surgery only | $102.33 | $162.18 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $20.42 | $32.36 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.49 | $21.38 | $25.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $151.36 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $95.50 | $151.36 | $177.83 |
Where Texas sits
The same service costs 3.5 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
$214
AK $759TX $214
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.