How much rates vary
Facilitymedian $240 · 10th to 90th $155 to $2,399Professionalmedian $191 · 10th to 90th $33 to $331
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 $426.58 Median $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $338.84 | Professional | None | $114.82 | $208.93 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $263.03 | Professional | None | $213.80 | $234.42 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $1,412.54 | Facility | None | $158.49 | $229.09 | $1,412.54 |
BCBS Texas Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $363.08 | Professional | None | $123.03 | $223.87 | $363.08 |
Baylor Scott & White Setting Facility Modifier None Typical Low $147.91 Median $407.38 Typical High $575.44 | Facility | None | $147.91 | $407.38 | $575.44 |
Baylor Scott & White Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $398.11 | Professional | None | $128.82 | $204.17 | $398.11 |
Christus Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
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 $158.49 Median $245.47 Typical High $338.84 | Professional | None | $158.49 | $245.47 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $954.99 Typical High $4,265.80 | Facility | None | $154.88 | $954.99 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $363.08 | Professional | None | $114.82 | $208.93 | $363.08 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $151.36 Typical High $257.04 | Professional | None | $29.51 | $151.36 | $257.04 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $234.42 Typical High $338.84 | Facility | None | $66.07 | $234.42 | $338.84 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $338.84 | Professional | None | $158.49 | $245.47 | $338.84 |
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 $125.89 Median $194.98 Typical High $302.00 | Professional | None | $125.89 | $194.98 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $57.54 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $39.81 Typical High $50.12 | Professional | 53 · Discontinued | $22.91 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $16.98 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $79.43 | $141.25 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $100.00 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $39.81 Typical High $50.12 | Professional | 53 · Discontinued | $22.91 | $39.81 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $151.36 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $16.98 | $29.51 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $25.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $138.04 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $79.43 | $138.04 | $177.83 |
Where Texas sits
The same service costs 3.5 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· 46th of 51
$204
AK $631KY $182
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.