How much rates vary
Facilitymedian $182 · 10th to 90th $44 to $3,715Professionalmedian $55 · 10th to 90th $12 to $120
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 $46.77 Median $3,715.35 Typical High $9,120.11 | Facility | None | $46.77 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $52.48 | Professional | None | $37.15 | $43.65 | $52.48 |
BCBS Texas Setting Facility Modifier None Typical Low $33.11 Median $64.57 Typical High $295.12 | Facility | None | $33.11 | $64.57 | $295.12 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $87.10 | Professional | None | $44.67 | $57.54 | $87.10 |
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 $46.77 Median $54.95 Typical High $72.44 | Professional | None | $46.77 | $54.95 | $72.44 |
Lucent Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $707.95 Typical High $5,248.07 | Facility | None | $40.74 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $61.66 | Professional | None | $37.15 | $43.65 | $61.66 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $74.13 | Professional | None | $9.77 | $53.70 | $74.13 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $61.66 Typical High $338.84 | Facility | None | $40.74 | $61.66 | $338.84 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $72.44 | Professional | None | $46.77 | $54.95 | $72.44 |
United Setting Facility Modifier None Typical Low $138.04 Median $741.31 Typical High $2,187.76 | Facility | None | $138.04 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $40.74 Median $52.48 Typical High $70.79 | Professional | None | $40.74 | $52.48 | $70.79 |
Wellpoint Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
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 $18.62 Median $21.88 Typical High $25.70 | Professional | 52 · Reduced service | $18.62 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.71 Typical High $10.23 | Professional | 53 · Discontinued | $7.41 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $33.11 Typical High $38.02 | Professional | 54 · Surgery only | $28.18 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.61 Typical High $7.59 | Professional | 55 · Aftercare only | $5.62 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.37 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.72 | $4.37 | $5.01 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.30 Median $30.90 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $26.30 | $30.90 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 52 · Reduced service | $18.62 | $21.88 | $25.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.71 Typical High $10.00 | Professional | 53 · Discontinued | $7.41 | $8.71 | $10.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $33.11 Typical High $38.02 | Professional | 54 · Surgery only | $28.18 | $33.11 | $38.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.61 Typical High $7.59 | Professional | 55 · Aftercare only | $5.62 | $6.61 | $7.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.37 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.72 | $4.37 | $5.01 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $26.30 Median $30.90 Typical High $35.48 | Professional | 78 · Unplanned return to OR | $26.30 | $30.90 | $35.48 |
Where Texas sits
The same service costs 4.6 times more in Alaska than in New York. 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· 32nd of 51
$56.23
AK $200NY $43.65
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.