How much rates vary
Facilitymedian $525 · 10th to 90th $195 to $3,715Professionalmedian $191 · 10th to 90th $32 to $316
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $288.40 | Professional | None | $131.83 | $223.87 | $288.40 |
BCBS Texas Setting Facility Modifier None Typical Low $169.82 Median $302.00 Typical High $1,819.70 | Facility | None | $169.82 | $302.00 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $489.78 | Professional | None | $147.91 | $245.47 | $489.78 |
Christus Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $263.03 Typical High $1,412.54 | Facility | None | $190.55 | $263.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $346.74 | Professional | None | $165.96 | $239.88 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $1,000.00 Typical High $4,677.35 | Facility | None | $154.88 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $288.40 | Professional | None | $131.83 | $223.87 | $288.40 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $263.03 | Professional | None | $29.51 | $162.18 | $263.03 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $3,801.89 | Facility | None | $199.53 | $331.13 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $346.74 | Professional | None | $165.96 | $239.88 | $346.74 |
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 $128.82 Median $208.93 Typical High $316.23 | Professional | None | $128.82 | $208.93 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $66.07 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $66.07 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $44.67 Typical High $54.95 | Professional | 53 · Discontinued | $26.30 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $97.72 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $19.50 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.18 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $91.20 | $158.49 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $66.07 | $112.20 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $44.67 Typical High $53.70 | Professional | 53 · Discontinued | $26.30 | $44.67 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $97.72 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $19.50 | $33.88 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.18 | $22.39 | $26.92 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $91.20 | $158.49 | $186.21 |
Where Texas sits
The same service costs 4.4 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· 48th of 51
$195
AK $661KY $151
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.