How much rates vary
Facilitymedian $251 · 10th to 90th $129 to $2,188Professionalmedian $204 · 10th to 90th $28 to $372
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 $354.81 Median $2,187.76 Typical High $6,760.83 | Facility | None | $354.81 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $363.08 | Professional | None | $128.82 | $223.87 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $245.47 Typical High $295.12 | Professional | None | $66.07 | $245.47 | $295.12 |
BCBS Setting Facility Modifier None Typical Low $97.72 Median $223.87 Typical High $1,348.96 | Facility | None | $97.72 | $223.87 | $1,348.96 |
BCBS Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $426.58 | Professional | None | $154.88 | $257.04 | $426.58 |
Baylor Scott & White Setting Professional Modifier None Typical Low $275.42 Median $295.12 Typical High $446.68 | Professional | None | $275.42 | $295.12 | $446.68 |
Christus Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $239.88 Typical High $338.84 | Facility | None | $66.07 | $239.88 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $363.08 | Professional | None | $177.83 | $263.03 | $363.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $660.69 Typical High $4,168.69 | Facility | None | $213.80 | $660.69 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $398.11 | Professional | None | $128.82 | $223.87 | $398.11 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $42.66 Typical High $263.03 | Professional | None | $5.89 | $42.66 | $263.03 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $245.47 Typical High $371.54 | Facility | None | $66.07 | $245.47 | $371.54 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $363.08 | Professional | None | $177.83 | $275.42 | $363.08 |
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 $141.25 Median $218.78 Typical High $331.13 | Professional | None | $141.25 | $218.78 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $64.57 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $64.57 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $25.70 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $162.18 Typical High $204.17 | Professional | 54 · Surgery only | $95.50 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $32.36 Typical High $40.74 | Professional | 55 · Aftercare only | $19.05 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $12.88 | $21.38 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $89.13 | $151.36 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $64.57 | $107.15 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $25.70 | $43.65 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $162.18 Typical High $204.17 | Professional | 54 · Surgery only | $95.50 | $162.18 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $32.36 Typical High $40.74 | Professional | 55 · Aftercare only | $19.05 | $32.36 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.38 Typical High $27.54 | Professional | 56 · Pre-op care only | $12.88 | $21.38 | $27.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $151.36 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $89.13 | $151.36 | $190.55 |
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· 48th of 51
$209
AK $692KY $204
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.