How much rates vary
Facilitymedian $575 · 10th to 90th $182 to $3,090Professionalmedian $170 · 10th to 90th $28 to $302
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $269.15 | Professional | None | $112.20 | $208.93 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
BCBS Texas Setting Facility Modifier None Typical Low $162.18 Median $275.42 Typical High $1,584.89 | Facility | None | $162.18 | $275.42 | $1,584.89 |
BCBS Texas Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $295.12 | Professional | None | $117.49 | $194.98 | $295.12 |
Christus Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $1,412.54 | Facility | None | $169.82 | $239.88 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $338.84 | Professional | None | $141.25 | $218.78 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,041.74 | Professional | None | $1,949.84 | $1,949.84 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $1,202.26 Typical High $5,248.07 | Facility | None | $194.98 | $1,202.26 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $269.15 | Professional | None | $112.20 | $208.93 | $269.15 |
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 $177.83 Median $323.59 Typical High $3,801.89 | Facility | None | $177.83 | $323.59 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $338.84 | Professional | None | $141.25 | $208.93 | $338.84 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,090.30 | Facility | None | $389.05 | $1,230.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $309.03 | Professional | None | $112.20 | $199.53 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $56.23 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $56.23 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $22.39 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $83.18 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $16.60 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $11.22 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $147.91 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $77.62 | $147.91 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $56.23 | $104.71 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $22.39 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $158.49 Typical High $190.55 | Professional | 54 · Surgery only | $83.18 | $158.49 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $31.62 Typical High $38.02 | Professional | 55 · Aftercare only | $16.60 | $31.62 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.22 | $20.89 | $25.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $147.91 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $77.62 | $147.91 | $177.83 |
Where Texas sits
The same service costs 3.6 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· 50th of 51
$178
AK $617KY $170
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.