How much rates vary
Facilitymedian $186 · 10th to 90th $74 to $2,570Professionalmedian $100 · 10th to 90th $19 to $174
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 $66.07 Median $100.00 Typical High $128.82 | Professional | None | $66.07 | $100.00 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
BCBS Texas Setting Facility Modifier None Typical Low $61.66 Median $109.65 Typical High $724.44 | Facility | None | $61.66 | $109.65 | $724.44 |
BCBS Texas Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $181.97 | Professional | None | $72.44 | $112.20 | $181.97 |
Christus Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $1,412.54 | Facility | None | $91.20 | $128.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $151.36 | Professional | None | $79.43 | $112.20 | $151.36 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | None | $851.14 | $1,071.52 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,230.27 Typical High $5,248.07 | Facility | None | $95.50 | $1,230.27 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $100.00 Typical High $128.82 | Professional | None | $66.07 | $100.00 | $128.82 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $93.33 Typical High $138.04 | Professional | None | $16.60 | $93.33 | $138.04 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $158.49 Typical High $3,801.89 | Facility | None | $97.72 | $158.49 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $151.36 | Professional | None | $79.43 | $112.20 | $151.36 |
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 $63.10 Median $91.20 Typical High $141.25 | Professional | None | $63.10 | $91.20 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $33.11 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $33.11 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $13.18 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $50.12 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $70.79 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $46.77 | $70.79 | $85.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $33.11 | $50.12 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $13.18 | $19.95 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $50.12 | $75.86 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $15.14 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $12.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $70.79 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $46.77 | $70.79 | $85.11 |
Where Texas sits
The same service costs 3.7 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· 42nd of 51
$102
AK $324KY $87.10
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.