How much rates vary
Facilitymedian $245 · 10th to 90th $151 to $2,188Professionalmedian $191 · 10th to 90th $32 to $339
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 $371.54 Median $2,187.76 Typical High $6,760.83 | Facility | None | $371.54 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $338.84 | Professional | None | $109.65 | $208.93 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $269.15 | Professional | None | $251.19 | $251.19 | $269.15 |
BCBS Texas Setting Facility Modifier None Typical Low $154.88 Median $229.09 Typical High $1,348.96 | Facility | None | $154.88 | $229.09 | $1,348.96 |
BCBS Texas Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $398.11 | Professional | None | $134.90 | $239.88 | $398.11 |
Christus Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $223.87 Typical High $331.13 | Facility | None | $66.07 | $223.87 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $338.84 | Professional | None | $154.88 | $245.47 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,905.46 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $588.84 Typical High $4,168.69 | Facility | None | $165.96 | $588.84 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $363.08 | Professional | None | $109.65 | $208.93 | $363.08 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $151.36 Typical High $257.04 | Professional | None | $28.84 | $151.36 | $257.04 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $229.09 Typical High $346.74 | Facility | None | $66.07 | $229.09 | $346.74 |
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 $204.17 Typical High $302.00 | Professional | None | $125.89 | $204.17 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
13 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 $54.95 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $21.88 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $81.28 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $16.22 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $20.42 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $75.86 | $141.25 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $54.95 | $100.00 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $21.88 | $40.74 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $81.28 | $151.36 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $16.22 | $30.20 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $19.95 | $25.70 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $123.03 Median $234.42 Typical High $457.09 | Professional | 59 · Distinct service | $123.03 | $234.42 | $457.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $138.04 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $75.86 | $138.04 | $177.83 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 47th of 51
$200
AK $631MD $186
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.