How much rates vary
Facilitymedian $288 · 10th to 90th $79 to $2,884Professionalmedian $91 · 10th to 90th $19 to $170
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $117.49 | Professional | None | $53.70 | $77.62 | $117.49 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
BCBS Texas Setting Facility Modifier None Typical Low $154.88 Median $316.23 Typical High $933.25 | Facility | None | $154.88 | $316.23 | $933.25 |
BCBS Texas Setting Professional Modifier None Typical Low $64.57 Median $95.50 Typical High $147.91 | Professional | None | $64.57 | $95.50 | $147.91 |
Christus Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
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 $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $831.76 | Professional | None | $724.44 | $724.44 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $1,000.00 Typical High $4,677.35 | Facility | None | $66.07 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $120.23 | Professional | None | $53.70 | $77.62 | $120.23 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $75.86 Typical High $154.88 | Facility | None | $50.12 | $75.86 | $154.88 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
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 $57.54 Median $83.18 Typical High $123.03 | Professional | None | $57.54 | $83.18 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $26.92 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $26.92 | $38.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $10.72 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $58.88 Typical High $70.79 | Professional | 54 · Surgery only | $39.81 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $8.13 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $54.95 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $37.15 | $54.95 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $38.90 Typical High $47.86 | Professional | 52 · Reduced service | $26.92 | $38.90 | $47.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $10.72 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $58.88 Typical High $70.79 | Professional | 54 · Surgery only | $39.81 | $58.88 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $8.13 | $11.75 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.37 | $7.76 | $9.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $54.95 Typical High $66.07 | Professional | 78 · Unplanned return to OR | $37.15 | $54.95 | $66.07 |
Where Texas sits
The same service costs 3.8 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· 39th of 51
$93.33
AK $288KY $75.86
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.