How much rates vary
Facilitymedian $257 · 10th to 90th $112 to $2,570Professionalmedian $186 · 10th to 90th $13 to $347
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 $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $316.23 | Professional | None | $229.09 | $257.04 | $316.23 |
BCBS Texas Setting Facility Modifier None Typical Low $107.15 Median $162.18 Typical High $954.99 | Facility | None | $107.15 | $162.18 | $954.99 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $467.74 | Professional | None | $251.19 | $323.59 | $467.74 |
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 $251.19 Median $309.03 Typical High $398.11 | Professional | None | $251.19 | $309.03 | $398.11 |
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 $2,041.74 Median $2,041.74 Typical High $2,691.53 | Professional | None | $2,041.74 | $2,041.74 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $263.03 Median $1,000.00 Typical High $4,677.35 | Facility | None | $263.03 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $354.81 | Professional | None | $234.42 | $263.03 | $354.81 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $56.23 Typical High $269.15 | Professional | None | $10.72 | $56.23 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,174.90 | Professional | None | $954.99 | $1,023.29 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $338.84 Typical High $3,801.89 | Facility | None | $158.49 | $338.84 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $398.11 | Professional | None | $245.47 | $309.03 | $398.11 |
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 $204.17 Median $263.03 Typical High $389.05 | Professional | None | $204.17 | $263.03 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $112.20 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $165.96 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $125.89 Typical High $147.91 | Professional | 52 · Reduced service | $112.20 | $125.89 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $44.67 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $190.55 Typical High $218.78 | Professional | 54 · Surgery only | $165.96 | $190.55 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.02 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $38.02 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $25.12 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.39 | $25.12 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $177.83 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $154.88 | $177.83 | $204.17 |
Where Texas sits
The same service costs 5.9 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
$186
AK $1,096TX $186
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.