How much rates vary
Facilitymedian $282 · 10th to 90th $123 to $2,951Professionalmedian $170 · 10th to 90th $30 to $309
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 $102.33 Median $162.18 Typical High $245.47 | Professional | None | $102.33 | $162.18 | $245.47 |
BCBS Texas Setting Facility Modifier None Typical Low $125.89 Median $213.80 Typical High $1,148.15 | Facility | None | $125.89 | $213.80 | $1,148.15 |
BCBS Texas Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $309.03 | Professional | None | $125.89 | $199.53 | $309.03 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $154.88 Typical High $229.09 | Facility | None | $66.07 | $154.88 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $281.84 | Professional | None | $131.83 | $194.98 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,513.56 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $1,000.00 Typical High $4,677.35 | Facility | None | $134.90 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $269.15 | Professional | None | $102.33 | $162.18 | $269.15 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $147.91 Typical High $208.93 | Professional | None | $27.54 | $147.91 | $208.93 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $263.03 | Facility | None | $66.07 | $165.96 | $263.03 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $281.84 | Professional | None | $131.83 | $194.98 | $281.84 |
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 $114.82 Median $169.82 Typical High $263.03 | Professional | None | $114.82 | $169.82 | $263.03 |
Wellpoint Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
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 $51.29 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $51.29 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $20.42 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $77.62 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.23 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $72.44 | $112.20 | $138.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $79.43 Typical High $100.00 | Professional | 52 · Reduced service | $51.29 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $31.62 Typical High $39.81 | Professional | 53 · Discontinued | $20.42 | $31.62 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $77.62 | $120.23 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $15.49 | $23.99 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $15.85 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.23 | $15.85 | $19.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $112.20 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $72.44 | $112.20 | $138.04 |
Where Texas sits
The same service costs 3.5 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
$174
AK $550MD $158
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.