How much rates vary
Facilitymedian $468 · 10th to 90th $174 to $3,467Professionalmedian $178 · 10th to 90th $27 to $331
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 $138.04 Median $229.09 Typical High $288.40 | Professional | None | $138.04 | $229.09 | $288.40 |
BCBS Texas Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $1,513.56 | Facility | None | $173.78 | $257.04 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $389.05 | Professional | None | $154.88 | $245.47 | $389.05 |
Christus Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $263.03 Typical High $1,412.54 | Facility | None | $186.21 | $263.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $1,000.00 Typical High $4,677.35 | Facility | None | $151.36 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $288.40 | Professional | None | $138.04 | $229.09 | $288.40 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $39.81 Typical High $234.42 | Professional | None | $6.03 | $39.81 | $234.42 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $338.84 Typical High $3,801.89 | Facility | None | $194.98 | $338.84 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $346.74 | Professional | None | $173.78 | $245.47 | $346.74 |
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 $134.90 Median $204.17 Typical High $316.23 | Professional | None | $134.90 | $204.17 | $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 $69.18 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $69.18 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $27.54 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $104.71 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $20.89 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $97.72 | $158.49 | $190.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $69.18 | $112.20 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $27.54 | $45.71 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $104.71 | $169.82 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $20.89 | $33.88 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.80 | $22.91 | $26.92 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $97.72 | $158.49 | $190.55 |
Where Texas sits
The same service costs 3.7 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
$186
AK $692UT $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.