How much rates vary
Facilitymedian $708 · 10th to 90th $112 to $3,715Professionalmedian $191 · 10th to 90th $35 to $355
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 $208.93 Median $3,715.35 Typical High $9,120.11 | Facility | None | $208.93 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $229.09 | Professional | None | $100.00 | $181.97 | $229.09 |
BCBS Texas Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $363.08 | Professional | None | $123.03 | $208.93 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $323.59 | Professional | None | $128.82 | $213.80 | $323.59 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,659.59 | $1,659.59 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $707.95 Typical High $5,248.07 | Facility | None | $114.82 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $181.97 Typical High $245.47 | Professional | None | $100.00 | $181.97 | $245.47 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $173.78 Typical High $245.47 | Professional | None | $32.36 | $173.78 | $245.47 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $354.81 | Facility | None | $50.12 | $138.04 | $354.81 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $323.59 | Professional | None | $128.82 | $208.93 | $323.59 |
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 $112.20 Median $190.55 Typical High $302.00 | Professional | None | $112.20 | $190.55 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $50.12 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $50.12 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $20.42 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $131.83 Typical High $165.96 | Professional | 54 · Surgery only | $75.86 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $15.14 | $26.30 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.00 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $123.03 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $70.79 | $123.03 | $154.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $87.10 Typical High $109.65 | Professional | 52 · Reduced service | $50.12 | $87.10 | $109.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $34.67 Typical High $44.67 | Professional | 53 · Discontinued | $20.42 | $34.67 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $128.82 Typical High $165.96 | Professional | 54 · Surgery only | $75.86 | $128.82 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.30 Typical High $33.11 | Professional | 55 · Aftercare only | $15.14 | $26.30 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $17.38 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.00 | $17.38 | $22.39 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $120.23 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $70.79 | $120.23 | $154.88 |
Where Texas sits
The same service costs 3.8 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· 41st of 51
$195
AK $603MD $158
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.