How much rates vary
Facilitymedian $589 · 10th to 90th $240 to $3,162Professionalmedian $295 · 10th to 90th $43 to $513
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 $660.69 Median $3,235.94 Typical High $8,511.38 | Facility | None | $660.69 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $489.78 | Professional | None | $186.21 | $309.03 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $380.19 | Professional | None | $186.21 | $316.23 | $380.19 |
BCBS Texas Setting Facility Modifier None Typical Low $323.59 Median $575.44 Typical High $1,905.46 | Facility | None | $323.59 | $575.44 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $602.56 | Professional | None | $223.87 | $371.54 | $602.56 |
Baylor Scott & White Setting Facility Modifier None Typical Low $245.47 Median $794.33 Typical High $4,677.35 | Facility | None | $245.47 | $794.33 | $4,677.35 |
Baylor Scott & White Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $575.44 | Professional | None | $114.82 | $234.42 | $575.44 |
Christus Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $2,691.53 | Facility | None | $407.38 | $562.34 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $537.03 | Professional | None | $257.04 | $398.11 | $537.03 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,818.38 | $2,818.38 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $1,995.26 Typical High $6,918.31 | Facility | None | $295.12 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $549.54 | Professional | None | $186.21 | $309.03 | $549.54 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $229.09 Typical High $363.08 | Professional | None | $32.36 | $229.09 | $363.08 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $630.96 Typical High $6,165.95 | Facility | None | $371.54 | $630.96 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $537.03 | Professional | None | $263.03 | $407.38 | $537.03 |
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 $213.80 Median $331.13 Typical High $501.19 | Professional | None | $213.80 | $331.13 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
14 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 $93.33 Median $151.36 Typical High $190.55 | Professional | 52 · Reduced service | $93.33 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $60.26 Typical High $75.86 | Professional | 53 · Discontinued | $37.15 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $141.25 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $28.18 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.20 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.62 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $213.80 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $131.83 | $213.80 | $269.15 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 59 · Distinct service | $371.54 | $371.54 | $436.52 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $870.96 Median $2,570.40 Typical High $3,019.95 | Facility | XU · Unusual separate service | $870.96 | $2,570.40 | $3,019.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $151.36 Typical High $190.55 | Professional | 52 · Reduced service | $93.33 | $151.36 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $60.26 Typical High $75.86 | Professional | 53 · Discontinued | $37.15 | $60.26 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $229.09 Typical High $288.40 | Professional | 54 · Surgery only | $141.25 | $229.09 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $45.71 Typical High $57.54 | Professional | 55 · Aftercare only | $28.18 | $45.71 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.20 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.62 | $30.20 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $213.80 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $131.83 | $213.80 | $269.15 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 50th of 51
$309
AK $1,000UT $302
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.