How much rates vary
Facilitymedian $490 · 10th to 90th $89 to $2,512Professionalmedian $129 · 10th to 90th $25 to $245
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $229.09 | Professional | None | $66.07 | $123.03 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $165.96 | Professional | None | $70.79 | $141.25 | $165.96 |
BCBS Texas Setting Facility Modifier None Typical Low $257.04 Median $537.03 Typical High $1,819.70 | Facility | None | $257.04 | $537.03 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $251.19 | Professional | None | $85.11 | $147.91 | $251.19 |
Christus Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $229.09 | Professional | None | $97.72 | $141.25 | $229.09 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $891.25 Typical High $4,265.80 | Facility | None | $91.20 | $891.25 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $123.03 Typical High $229.09 | Professional | None | $66.07 | $123.03 | $229.09 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $173.78 | Professional | None | $21.88 | $117.49 | $173.78 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $100.00 Typical High $245.47 | Facility | None | $50.12 | $100.00 | $245.47 |
Providence Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $229.09 | Professional | None | $97.72 | $147.91 | $229.09 |
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 $75.86 Median $128.82 Typical High $194.98 | Professional | None | $75.86 | $128.82 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
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 $33.11 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $33.11 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $13.18 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $89.13 Typical High $109.65 | Professional | 54 · Surgery only | $50.12 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $10.00 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.61 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $83.18 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $46.77 | $83.18 | $102.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $33.11 | $60.26 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $13.18 | $23.99 | $28.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $89.13 Typical High $109.65 | Professional | 54 · Surgery only | $50.12 | $89.13 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $10.00 | $17.78 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $6.61 | $12.02 | $14.45 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $83.18 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $46.77 | $83.18 | $102.33 |
Where Texas sits
The same service costs 4.5 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· 39th of 51
$138
AK $407KY $91.20
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.