How much rates vary
Facilitymedian $447 · 10th to 90th $186 to $2,754Professionalmedian $282 · 10th to 90th $42 to $490
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 $616.60 Median $2,570.40 Typical High $6,918.31 | Facility | None | $616.60 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $537.03 | Professional | None | $162.18 | $302.00 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $1,230.27 | Facility | None | $186.21 | $380.19 | $1,230.27 |
BCBS Texas Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $575.44 | Professional | None | $204.17 | $346.74 | $575.44 |
Christus Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $316.23 Typical High $1,862.09 | Facility | None | $218.78 | $316.23 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $501.19 | Professional | None | $234.42 | $354.81 | $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 $229.09 Median $1,174.90 Typical High $4,677.35 | Facility | None | $229.09 | $1,174.90 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $537.03 | Professional | None | $162.18 | $302.00 | $537.03 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $380.19 | Professional | None | $33.11 | $229.09 | $380.19 |
Providence Setting Facility Modifier None Typical Low $239.88 Median $467.74 Typical High $4,466.84 | Facility | None | $239.88 | $467.74 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $501.19 | Professional | None | $234.42 | $346.74 | $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 $181.97 Median $295.12 Typical High $457.09 | Professional | None | $181.97 | $295.12 | $457.09 |
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 $81.28 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $81.28 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $32.36 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $123.03 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $24.55 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $29.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.22 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $114.82 | $204.17 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $81.28 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $81.28 | $144.54 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $32.36 | $57.54 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $123.03 | $218.78 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $24.55 | $43.65 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $16.22 | $28.84 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $114.82 | $204.17 | $257.04 |
Where Texas sits
The same service costs 3.5 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
$295
AK $891MD $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.