How much rates vary
Facilitymedian $282 · 10th to 90th $95 to $2,884Professionalmedian $98 · 10th to 90th $21 to $166
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 $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $141.25 | Professional | None | $51.29 | $89.13 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $117.49 | Professional | None | $83.18 | $107.15 | $117.49 |
BCBS Texas Setting Facility Modifier None Typical Low $144.54 Median $288.40 Typical High $1,548.82 | Facility | None | $144.54 | $288.40 | $1,548.82 |
BCBS Texas Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $162.18 | Professional | None | $56.23 | $100.00 | $162.18 |
Baylor Scott & White Setting Professional Modifier None Typical Low $34.67 Median $107.15 Typical High $144.54 | Professional | None | $34.67 | $107.15 | $144.54 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
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 $66.07 Median $102.33 Typical High $151.36 | Professional | None | $66.07 | $102.33 | $151.36 |
Health Smart Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $181.97 | Professional | None | $102.33 | $154.88 | $181.97 |
Lucent Health Setting Professional Modifier None Typical Low $154.88 Median $812.83 Typical High $954.99 | Professional | None | $154.88 | $812.83 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $630.96 Typical High $4,786.30 | Facility | None | $81.28 | $630.96 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $162.18 | Professional | None | $51.29 | $91.20 | $162.18 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $89.13 Typical High $138.04 | Professional | None | $16.60 | $89.13 | $138.04 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $338.84 | Facility | None | $50.12 | $83.18 | $338.84 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $151.36 | Professional | None | $66.07 | $104.71 | $151.36 |
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 $54.95 Median $89.13 Typical High $138.04 | Professional | None | $54.95 | $89.13 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $25.70 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $25.70 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $10.23 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $64.57 Typical High $81.28 | Professional | 54 · Surgery only | $38.02 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.88 Typical High $16.22 | Professional | 55 · Aftercare only | $7.59 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.13 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $60.26 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $35.48 | $60.26 | $75.86 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 59 · Distinct service | $91.20 | $107.15 | $112.20 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 79 · Unrelated procedure after surgery | $91.20 | $91.20 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $25.70 | $42.66 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $10.23 | $16.98 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $64.57 Typical High $81.28 | Professional | 54 · Surgery only | $38.02 | $64.57 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.88 Typical High $16.22 | Professional | 55 · Aftercare only | $7.59 | $12.88 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.13 | $8.51 | $10.72 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $52.48 Median $89.13 Typical High $169.82 | Professional | 59 · Distinct service | $52.48 | $89.13 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $60.26 Typical High $75.86 | Professional | 78 · Unplanned return to OR | $35.48 | $60.26 | $75.86 |
Where Texas sits
The same service costs 3.9 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· 40th of 51
$102
AK $309KY $79.43
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.