How much rates vary
Facilitymedian $295 · 10th to 90th $135 to $2,692Professionalmedian $148 · 10th to 90th $27 to $257
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 $91.20 Median $151.36 Typical High $213.80 | Professional | None | $91.20 | $151.36 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $371.54 | Professional | None | $239.88 | $354.81 | $371.54 |
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 $112.20 Median $181.97 Typical High $288.40 | Professional | None | $112.20 | $181.97 | $288.40 |
Baylor Scott & White Setting Professional Modifier None Typical Low $97.72 Median $181.97 Typical High $245.47 | Professional | None | $97.72 | $181.97 | $245.47 |
Christus Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
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 $117.49 Median $181.97 Typical High $257.04 | Professional | None | $117.49 | $181.97 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,412.54 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $1,000.00 Typical High $4,677.35 | Facility | None | $120.23 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $257.04 | Professional | None | $91.20 | $151.36 | $257.04 |
Molina Setting Professional Modifier None Typical Low $22.91 Median $125.89 Typical High $194.98 | Professional | None | $22.91 | $125.89 | $194.98 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $128.82 Typical High $288.40 | Facility | None | $56.23 | $128.82 | $288.40 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $257.04 | Professional | None | $117.49 | $181.97 | $257.04 |
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 $102.33 Median $158.49 Typical High $239.88 | Professional | None | $102.33 | $158.49 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $45.71 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $45.71 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $18.20 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $69.18 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $13.80 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $64.57 | $102.33 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $45.71 | $72.44 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $18.20 | $29.51 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $69.18 | $109.65 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $13.80 | $21.88 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $18.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $102.33 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $64.57 | $102.33 | $128.82 |
Where Texas sits
The same service costs 3.3 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· 47th of 51
$155
AK $490MD $148
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.