How much rates vary
Facilitymedian $331 · 10th to 90th $138 to $2,291Professionalmedian $234 · 10th to 90th $26 to $447
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 $263.03 Median $309.03 Typical High $446.68 | Professional | None | $263.03 | $309.03 | $446.68 |
BCBS Texas Setting Facility Modifier None Typical Low $125.89 Median $257.04 Typical High $870.96 | Facility | None | $125.89 | $257.04 | $870.96 |
BCBS Texas Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $512.86 | Professional | None | $263.03 | $331.13 | $512.86 |
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 $302.00 Median $371.54 Typical High $501.19 | Professional | None | $302.00 | $371.54 | $501.19 |
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 $2,511.89 Median $2,511.89 Typical High $3,235.94 | Professional | None | $2,511.89 | $2,511.89 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $309.03 Median $1,000.00 Typical High $4,570.88 | Facility | None | $309.03 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $478.63 | Professional | None | $263.03 | $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 $1,148.15 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,202.26 | $1,412.54 |
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 $295.12 Median $371.54 Typical High $501.19 | Professional | None | $295.12 | $371.54 | $501.19 |
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 $245.47 Median $316.23 Typical High $478.63 | Professional | None | $245.47 | $316.23 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $131.83 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $131.83 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $52.48 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $199.53 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $39.81 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $186.21 | $218.78 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $131.83 | $154.88 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $52.48 | $61.66 | $72.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $199.53 | $234.42 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $39.81 | $46.77 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $36.31 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $218.78 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $186.21 | $218.78 | $251.19 |
Where Texas sits
The same service costs 5.9 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
$234
AK $1,288UT $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.