How much rates vary
Facilitymedian $575 · 10th to 90th $240 to $3,090Professionalmedian $234 · 10th to 90th $24 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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $407.38 | Professional | None | $218.78 | $323.59 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | None | $239.88 | $251.19 | $251.19 |
BCBS Texas Setting Facility Modifier None Typical Low $229.09 Median $346.74 Typical High $2,187.76 | Facility | None | $229.09 | $346.74 | $2,187.76 |
BCBS Texas Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $562.34 | Professional | None | $245.47 | $354.81 | $562.34 |
Christus Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $346.74 Typical High $588.84 | Facility | None | $66.07 | $346.74 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $489.78 | Professional | None | $275.42 | $371.54 | $489.78 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $1,819.70 Typical High $6,025.60 | Facility | None | $338.84 | $1,819.70 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $407.38 | Professional | None | $218.78 | $323.59 | $407.38 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $81.28 Typical High $354.81 | Professional | None | $16.22 | $81.28 | $354.81 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $363.08 Typical High $537.03 | Facility | None | $66.07 | $363.08 | $537.03 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $371.54 Typical High $489.78 | Professional | None | $269.15 | $371.54 | $489.78 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $457.09 | Professional | None | $213.80 | $309.03 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $109.65 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $239.88 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $47.86 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $223.87 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $151.36 | $223.87 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $162.18 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $64.57 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $162.18 | $239.88 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $32.36 | $47.86 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $223.87 | $269.15 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 51st of 51
$240
AK $1,072TX $240
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.