How much rates vary
Facilitymedian $1,514 · 10th to 90th $631 to $3,890Professionalmedian $200 · 10th to 90th $26 to $363
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 $204.17 Median $223.87 Typical High $263.03 | Professional | None | $204.17 | $223.87 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $812.83 Median $1,548.82 Typical High $3,801.89 | Facility | None | $812.83 | $1,548.82 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $398.11 | Professional | None | $229.09 | $288.40 | $398.11 |
Christus Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,659.59 | Facility | None | $457.09 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $363.08 | Professional | None | $223.87 | $281.84 | $363.08 |
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 $1,819.70 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,819.70 | $1,819.70 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,000.00 Typical High $4,570.88 | Facility | None | $234.42 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $323.59 | Professional | None | $204.17 | $229.09 | $323.59 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $39.81 Typical High $234.42 | Professional | None | $6.03 | $39.81 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,023.29 | Professional | None | $870.96 | $933.25 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $1,096.48 Typical High $3,801.89 | Facility | None | $309.03 | $1,096.48 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $363.08 | Professional | None | $223.87 | $281.84 | $363.08 |
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 $181.97 Median $229.09 Typical High $346.74 | Professional | None | $181.97 | $229.09 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $102.33 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $102.33 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $40.74 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $154.88 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $158.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $144.54 | $158.49 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $102.33 | $112.20 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $40.74 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $154.88 | $169.82 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $20.42 | $22.39 | $26.30 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $144.54 | $158.49 | $181.97 |
Where Texas sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 50th of 51
$204
AK $1,023UT $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.