How much rates vary
Facilitymedian $148 · 10th to 90th $62 to $3,162Professionalmedian $105 · 10th to 90th $19 to $437
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 $74.13 Median $104.71 Typical High $131.83 | Professional | None | $74.13 | $104.71 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $54.95 Median $91.20 Typical High $588.84 | Facility | None | $54.95 | $91.20 | $588.84 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $177.83 | Professional | None | $83.18 | $114.82 | $177.83 |
Christus Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $151.36 | Facility | None | $66.07 | $102.33 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $162.18 | Professional | None | $91.20 | $123.03 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,479.11 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $1,000.00 Typical High $4,677.35 | Facility | None | $91.20 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $154.88 | Professional | None | $74.13 | $104.71 | $154.88 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $85.11 Typical High $109.65 | Professional | None | $14.79 | $85.11 | $109.65 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $173.78 | Facility | None | $66.07 | $109.65 | $173.78 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $162.18 | Professional | None | $91.20 | $120.23 | $162.18 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $158.49 | Professional | None | $72.44 | $100.00 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
13 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 $37.15 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $37.15 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $25.70 | Professional | 53 · Discontinued | $14.79 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $77.62 Typical High $95.50 | Professional | 54 · Surgery only | $54.95 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $10.96 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $72.44 Typical High $89.13 | Professional | 78 · Unplanned return to OR | $51.29 | $72.44 | $89.13 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 59 · Distinct service | $81.28 | $81.28 | $81.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $37.15 | $52.48 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $14.79 | $20.89 | $25.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $77.62 Typical High $93.33 | Professional | 54 · Surgery only | $54.95 | $77.62 | $93.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $10.96 | $15.49 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $7.41 | $10.47 | $12.59 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $51.29 Median $72.44 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $51.29 | $72.44 | $87.10 |
Where Texas sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 49th of 51
$105
AK $363FL $91.20
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.