How much rates vary
Facilitymedian $275 · 10th to 90th $141 to $2,188Professionalmedian $219 · 10th to 90th $25 to $437
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 $257.04 Median $302.00 Typical High $436.52 | Professional | None | $257.04 | $302.00 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
BCBS Texas Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $851.14 | Facility | None | $125.89 | $257.04 | $851.14 |
BCBS Texas Setting Professional Modifier None Typical Low $288.40 Median $371.54 Typical High $537.03 | Professional | None | $288.40 | $371.54 | $537.03 |
Christus Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $295.12 Median $363.08 Typical High $478.63 | Professional | None | $295.12 | $363.08 | $478.63 |
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 $2,454.71 Median $2,454.71 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,454.71 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $302.00 Median $1,000.00 Typical High $4,570.88 | Facility | None | $302.00 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $478.63 | Professional | None | $275.42 | $309.03 | $478.63 |
Molina Setting Professional Modifier None Typical Low $16.98 Median $83.18 Typical High $346.74 | Professional | None | $16.98 | $83.18 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,096.48 | $1,174.90 | $1,380.38 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $407.38 Typical High $3,801.89 | Facility | None | $158.49 | $407.38 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $478.63 | Professional | None | $288.40 | $363.08 | $478.63 |
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 $234.42 Median $309.03 Typical High $457.09 | Professional | None | $234.42 | $309.03 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $128.82 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $128.82 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $51.29 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $229.09 Typical High $269.15 | Professional | 54 · Surgery only | $194.98 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $251.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $128.82 | $151.36 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $51.29 | $61.66 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $229.09 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $245.47 |
Where Texas sits
The same service costs 5.8 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
$224
AK $1,259UT $219
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.