How much rates vary
Facilitymedian $309 · 10th to 90th $132 to $3,090Professionalmedian $126 · 10th to 90th $17 to $501
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 $398.11 Median $3,715.35 Typical High $9,120.11 | Facility | None | $398.11 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $446.68 | Professional | None | $269.15 | $346.74 | $446.68 |
BCBS Texas Setting Facility Modifier None Typical Low $97.72 Median $234.42 Typical High $1,479.11 | Facility | None | $97.72 | $234.42 | $1,479.11 |
BCBS Texas Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $1,258.93 | Professional | None | $323.59 | $457.09 | $1,258.93 |
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 $229.09 Median $316.23 Typical High $1,412.54 | Facility | None | $229.09 | $316.23 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $616.60 | Professional | None | $338.84 | $457.09 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,801.89 | Professional | None | $3,311.31 | $3,311.31 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $724.44 Typical High $5,248.07 | Facility | None | $309.03 | $724.44 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $467.74 | Professional | None | $269.15 | $346.74 | $467.74 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $69.18 Typical High $363.08 | Professional | None | $14.79 | $69.18 | $363.08 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $426.58 Typical High $3,801.89 | Facility | None | $263.03 | $426.58 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $616.60 | Professional | None | $338.84 | $457.09 | $616.60 |
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 $295.12 Median $426.58 Typical High $616.60 | Professional | None | $295.12 | $426.58 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $134.90 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $134.90 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $53.70 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $323.59 | Professional | 54 · Surgery only | $199.53 | $257.04 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $173.78 | $213.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $69.18 | $85.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $199.53 | $257.04 | $316.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $63.10 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $63.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $42.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $239.88 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $186.21 | $239.88 | $295.12 |
Where Texas sits
The same service costs 6.0 times more in Alaska than in Texas. 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· 51st of 51
$240
AK $1,445TX $240
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.