How much rates vary
Facilitymedian $603 · 10th to 90th $288 to $3,020Professionalmedian $316 · 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 $208.93 Median $331.13 Typical High $537.03 | Professional | None | $208.93 | $331.13 | $537.03 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $407.38 | Professional | None | $181.97 | $213.80 | $407.38 |
BCBS Texas Setting Facility Modifier None Typical Low $316.23 Median $602.56 Typical High $1,905.46 | Facility | None | $316.23 | $602.56 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $630.96 | Professional | None | $229.09 | $371.54 | $630.96 |
Baylor Scott & White Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $363.08 | Professional | None | $229.09 | $263.03 | $363.08 |
Christus Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
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 $295.12 Median $436.52 Typical High $575.44 | Professional | None | $295.12 | $436.52 | $575.44 |
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 $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $1,621.81 Typical High $5,248.07 | Facility | None | $302.00 | $1,621.81 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $575.44 | Professional | None | $208.93 | $331.13 | $575.44 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $229.09 Typical High $416.87 | Professional | None | $33.11 | $229.09 | $416.87 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $645.65 Typical High $6,165.95 | Facility | None | $398.11 | $645.65 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $575.44 | Professional | None | $295.12 | $436.52 | $575.44 |
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 $239.88 Median $354.81 Typical High $524.81 | Professional | None | $239.88 | $354.81 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $104.71 Median $165.96 Typical High $204.17 | Professional | 52 · Reduced service | $104.71 | $165.96 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $66.07 Typical High $81.28 | Professional | 53 · Discontinued | $41.69 | $66.07 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $158.49 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $31.62 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.11 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.89 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $229.09 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $147.91 | $229.09 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $104.71 | $162.18 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $41.69 | $64.57 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $158.49 | $245.47 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $31.62 | $48.98 | $60.26 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.89 | $32.36 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $229.09 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $147.91 | $229.09 | $281.84 |
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· 50th of 51
$331
AK $1,122KY $331
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.