How much rates vary
Facilitymedian $288 · 10th to 90th $52 to $2,399Professionalmedian $58 · 10th to 90th $10 to $102
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $93.33 | Professional | None | $41.69 | $57.54 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $67.61 | Professional | None | $54.95 | $61.66 | $67.61 |
BCBS Texas Setting Facility Modifier None Typical Low $144.54 Median $295.12 Typical High $1,548.82 | Facility | None | $144.54 | $295.12 | $1,548.82 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $63.10 Typical High $104.71 | Professional | None | $44.67 | $63.10 | $104.71 |
Baylor Scott & White Setting Professional Modifier None Typical Low $27.54 Median $54.95 Typical High $85.11 | Professional | None | $27.54 | $54.95 | $85.11 |
Christus Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
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 $52.48 Median $67.61 Typical High $91.20 | Professional | None | $52.48 | $67.61 | $91.20 |
Health Smart Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $112.20 | Professional | None | $79.43 | $93.33 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $95.50 Median $501.19 Typical High $575.44 | Professional | None | $95.50 | $501.19 | $575.44 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $575.44 Typical High $4,168.69 | Facility | None | $48.98 | $575.44 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $60.26 Typical High $93.33 | Professional | None | $41.69 | $60.26 | $93.33 |
Molina Setting Professional Modifier None Typical Low $5.37 Median $28.84 Typical High $69.18 | Professional | None | $5.37 | $28.84 | $69.18 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $66.07 Typical High $338.84 | Facility | None | $48.98 | $66.07 | $338.84 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $91.20 | Professional | None | $52.48 | $67.61 | $91.20 |
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 $44.67 Median $60.26 Typical High $89.13 | Professional | None | $44.67 | $60.26 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
15 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 $20.89 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $20.89 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $8.32 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $38.90 Typical High $48.98 | Professional | 54 · Surgery only | $31.62 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.76 Typical High $9.77 | Professional | 55 · Aftercare only | $6.31 | $7.76 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.17 | $5.25 | $6.46 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $36.31 Typical High $45.71 | Professional | 78 · Unplanned return to OR | $29.51 | $36.31 | $45.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $54.95 Median $64.57 Typical High $67.61 | Professional | 59 · Distinct service | $54.95 | $64.57 | $67.61 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $54.95 Median $54.95 Typical High $67.61 | Professional | 79 · Unrelated procedure after surgery | $54.95 | $54.95 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $26.30 Typical High $31.62 | Professional | 52 · Reduced service | $20.89 | $26.30 | $31.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $8.32 | $10.47 | $12.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $38.90 Typical High $47.86 | Professional | 54 · Surgery only | $31.62 | $38.90 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.76 Typical High $9.55 | Professional | 55 · Aftercare only | $6.31 | $7.76 | $9.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.25 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.17 | $5.25 | $6.31 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $25.12 Median $48.98 Typical High $128.82 | Professional | 59 · Distinct service | $25.12 | $48.98 | $128.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $29.51 Median $36.31 Typical High $44.67 | Professional | 78 · Unplanned return to OR | $29.51 | $36.31 | $44.67 |
Where Texas sits
The same service costs 4.2 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· 48th of 51
$60.26
AK $224KY $53.70
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.