How much rates vary
Facilitymedian $631 · 10th to 90th $141 to $3,715Professionalmedian $295 · 10th to 90th $24 to $550
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 $426.58 Median $3,715.35 Typical High $9,120.11 | Facility | None | $426.58 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $660.69 | Professional | None | $269.15 | $371.54 | $660.69 |
BCBS Texas Setting Facility Modifier None Typical Low $309.03 Median $575.44 Typical High $1,621.81 | Facility | None | $309.03 | $575.44 | $1,621.81 |
BCBS Texas Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $724.44 | Professional | None | $331.13 | $457.09 | $724.44 |
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 $346.74 Median $467.74 Typical High $645.65 | Professional | None | $346.74 | $467.74 | $645.65 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,073.80 | Professional | None | $3,467.37 | $3,467.37 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $316.23 Median $724.44 Typical High $5,248.07 | Facility | None | $316.23 | $724.44 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $660.69 | Professional | None | $275.42 | $426.58 | $660.69 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $79.43 Typical High $407.38 | Professional | None | $16.22 | $79.43 | $407.38 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $316.23 Typical High $645.65 | Facility | None | $56.23 | $316.23 | $645.65 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $645.65 | Professional | None | $346.74 | $467.74 | $645.65 |
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 $288.40 Median $416.87 Typical High $616.60 | Professional | None | $288.40 | $416.87 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $181.97 Typical High $229.09 | Professional | 52 · Reduced service | $134.90 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $74.13 Typical High $91.20 | Professional | 53 · Discontinued | $53.70 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $275.42 Typical High $346.74 | Professional | 54 · Surgery only | $204.17 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $69.18 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $36.31 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.92 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $257.04 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $190.55 | $257.04 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $134.90 | $181.97 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $74.13 Typical High $89.13 | Professional | 53 · Discontinued | $53.70 | $74.13 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $275.42 Typical High $338.84 | Professional | 54 · Surgery only | $204.17 | $275.42 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $67.61 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.92 | $36.31 | $44.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $257.04 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $190.55 | $257.04 | $316.23 |
Where Texas sits
The same service costs 4.7 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
$309
AK $1,445TX $309
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.