How much rates vary
Facilitymedian $275 · 10th to 90th $141 to $2,188Professionalmedian $234 · 10th to 90th $25 to $417
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 $524.81 Median $2,187.76 Typical High $6,760.83 | Facility | None | $524.81 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $416.87 | Professional | None | $245.47 | $295.12 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $245.47 Median $309.03 Typical High $489.78 | Professional | None | $245.47 | $309.03 | $489.78 |
Christus Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
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 $281.84 Median $346.74 Typical High $467.74 | Professional | None | $281.84 | $346.74 | $467.74 |
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 $2,344.23 Median $2,344.23 Typical High $3,019.95 | Professional | None | $2,344.23 | $2,344.23 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $933.25 Typical High $4,365.16 | Facility | None | $281.84 | $933.25 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $416.87 | Professional | None | $245.47 | $295.12 | $416.87 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $61.66 Typical High $323.59 | Professional | None | $10.72 | $61.66 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,047.13 | $1,122.02 | $1,318.26 |
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 $275.42 Median $346.74 Typical High $467.74 | Professional | None | $275.42 | $346.74 | $467.74 |
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 $229.09 Median $295.12 Typical High $446.68 | Professional | None | $229.09 | $295.12 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $123.03 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $123.03 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | 53 · Discontinued | $50.12 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $218.78 Typical High $257.04 | Professional | 54 · Surgery only | $186.21 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $51.29 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $204.17 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $173.78 | $204.17 | $239.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $123.03 | $147.91 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $218.78 Typical High $257.04 | Professional | 54 · Surgery only | $186.21 | $218.78 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $51.29 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $204.17 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $173.78 | $204.17 | $239.88 |
Where Texas sits
The same service costs 5.5 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 $1,202UT $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.