How much rates vary
Facilitymedian $603 · 10th to 90th $275 to $2,570Professionalmedian $263 · 10th to 90th $38 to $479
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $537.03 | Professional | None | $162.18 | $295.12 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $602.56 | Professional | None | $309.03 | $371.54 | $602.56 |
BCBS Texas Setting Facility Modifier None Typical Low $288.40 Median $588.84 Typical High $1,862.09 | Facility | None | $288.40 | $588.84 | $1,862.09 |
BCBS Texas Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $575.44 | Professional | None | $199.53 | $346.74 | $575.44 |
Christus Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $537.03 Typical High $1,862.09 | Facility | None | $398.11 | $537.03 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $501.19 | Professional | None | $229.09 | $323.59 | $501.19 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,754.23 | $2,754.23 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $977.24 Typical High $4,570.88 | Facility | None | $204.17 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $537.03 | Professional | None | $162.18 | $295.12 | $537.03 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $199.53 Typical High $363.08 | Professional | None | $32.36 | $199.53 | $363.08 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $602.56 Typical High $4,466.84 | Facility | None | $371.54 | $602.56 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $331.13 Typical High $501.19 | Professional | None | $229.09 | $331.13 | $501.19 |
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 $177.83 Median $288.40 Typical High $446.68 | Professional | None | $177.83 | $288.40 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $79.43 Median $144.54 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $57.54 Typical High $72.44 | Professional | 53 · Discontinued | $32.36 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $23.99 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $28.84 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.22 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $112.20 | $204.17 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $141.25 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $141.25 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $57.54 Typical High $72.44 | Professional | 53 · Discontinued | $32.36 | $57.54 | $72.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $213.80 Typical High $275.42 | Professional | 54 · Surgery only | $120.23 | $213.80 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $42.66 Typical High $54.95 | Professional | 55 · Aftercare only | $23.99 | $42.66 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $28.84 Typical High $36.31 | Professional | 56 · Pre-op care only | $16.22 | $28.84 | $36.31 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $199.53 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $112.20 | $199.53 | $257.04 |
Where Texas sits
The same service costs 3.4 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· 47th of 51
$295
AK $871KY $257
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.