How much rates vary
Facilitymedian $479 · 10th to 90th $166 to $3,548Professionalmedian $219 · 10th to 90th $14 to $389
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 $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $346.74 | Professional | None | $251.19 | $288.40 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
BCBS Texas Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $1,737.80 | Facility | None | $223.87 | $407.38 | $1,737.80 |
BCBS Texas Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $512.86 | Professional | None | $281.84 | $354.81 | $512.86 |
Christus Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $194.98 Typical High $1,412.54 | Facility | None | $138.04 | $194.98 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $457.09 | Professional | None | $281.84 | $338.84 | $457.09 |
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 $2,290.87 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,290.87 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $1,000.00 Typical High $4,570.88 | Facility | None | $295.12 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $398.11 | Professional | None | $251.19 | $288.40 | $398.11 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $60.26 Typical High $323.59 | Professional | None | $10.96 | $60.26 | $323.59 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $398.11 Typical High $3,801.89 | Facility | None | $158.49 | $398.11 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $457.09 | Professional | None | $275.42 | $338.84 | $457.09 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $436.52 | Professional | None | $229.09 | $288.40 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $125.89 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $50.12 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $186.21 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $173.78 | $199.53 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $144.54 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $144.54 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $50.12 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $186.21 | $213.80 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $50.12 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $33.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $173.78 | $199.53 | $234.42 |
Where Texas sits
The same service costs 5.5 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
$224
AK $1,230TX $224
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.