How much rates vary
Facilitymedian $1,660 · 10th to 90th $617 to $3,802Professionalmedian $245 · 10th to 90th $36 to $447
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 $467.74 Median $2,187.76 Typical High $6,760.83 | Facility | None | $467.74 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $316.23 Typical High $416.87 | Professional | None | $120.23 | $316.23 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $338.84 Typical High $354.81 | Professional | None | $128.82 | $338.84 | $354.81 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $3,801.89 | Facility | None | $691.83 | $1,445.44 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $134.90 Median $309.03 Typical High $512.86 | Professional | None | $134.90 | $309.03 | $512.86 |
Christus Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $1,659.59 | Facility | None | $457.09 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $501.19 | Professional | None | $154.88 | $275.42 | $501.19 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,884.03 | $2,884.03 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $1,584.89 Typical High $5,128.61 | Facility | None | $147.91 | $1,584.89 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $316.23 Typical High $426.58 | Professional | None | $120.23 | $316.23 | $426.58 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $208.93 Typical High $363.08 | Professional | None | $32.36 | $208.93 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $1,380.38 | Professional | None | $501.19 | $524.81 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $977.24 Typical High $3,801.89 | Facility | None | $338.84 | $977.24 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $501.19 | Professional | None | $154.88 | $263.03 | $501.19 |
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 $120.23 Median $275.42 Typical High $501.19 | Professional | None | $120.23 | $275.42 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
14 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 $60.26 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $60.26 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $24.55 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $91.20 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $18.20 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $12.02 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $85.11 | $218.78 | $263.03 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $114.82 Median $245.47 Typical High $354.81 | Professional | 58 · Staged procedure | $114.82 | $245.47 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $60.26 | $158.49 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $24.55 | $63.10 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $91.20 | $234.42 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $18.20 | $46.77 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.02 | $31.62 | $37.15 |
Moda Health Setting Professional Modifier 58 · Staged procedure Typical Low $389.05 Median $524.81 Typical High $977.24 | Professional | 58 · Staged procedure | $389.05 | $524.81 | $977.24 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $85.11 | $218.78 | $263.03 |
Where Texas sits
The same service costs 4.0 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· 47th of 51
$263
AK $759KY $191
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.