How much rates vary
Facilitymedian $269 · 10th to 90th $158 to $2,399Professionalmedian $229 · 10th to 90th $29 to $407
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 $407.38 Median $2,187.76 Typical High $6,760.83 | Facility | None | $407.38 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $416.87 | Professional | None | $151.36 | $245.47 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $275.42 Typical High $389.05 | Professional | None | $83.18 | $275.42 | $389.05 |
BCBS Texas Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $1,479.11 | Facility | None | $158.49 | $234.42 | $1,479.11 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $436.52 | Professional | None | $162.18 | $275.42 | $436.52 |
Baylor Scott & White Setting Professional Modifier None Typical Low $97.72 Median $309.03 Typical High $478.63 | Professional | None | $97.72 | $309.03 | $478.63 |
Christus Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $251.19 Typical High $346.74 | Facility | None | $66.07 | $251.19 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $407.38 | Professional | None | $208.93 | $309.03 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,290.87 | $2,290.87 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $758.58 Typical High $3,715.35 | Facility | None | $251.19 | $758.58 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $426.58 | Professional | None | $151.36 | $245.47 | $426.58 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $46.77 Typical High $295.12 | Professional | None | $5.89 | $46.77 | $295.12 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $263.03 Typical High $407.38 | Facility | None | $66.07 | $263.03 | $407.38 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $407.38 | Professional | None | $208.93 | $309.03 | $407.38 |
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 $165.96 Median $251.19 Typical High $371.54 | Professional | None | $165.96 | $251.19 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $75.86 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $30.20 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $112.20 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $22.39 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $104.71 | $169.82 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $75.86 | $120.23 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $30.20 | $47.86 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $112.20 | $186.21 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $22.39 | $36.31 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $30.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $104.71 | $169.82 | $213.80 |
Where Texas sits
The same service costs 3.7 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· 49th of 51
$229
AK $813MD $219
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.