How much rates vary
Facilitymedian $224 · 10th to 90th $110 to $2,188Professionalmedian $182 · 10th to 90th $26 to $295
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 $457.09 Median $2,187.76 Typical High $6,760.83 | Facility | None | $457.09 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $281.84 | Professional | None | $177.83 | $204.17 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | None | $218.78 | $218.78 | $239.88 |
BCBS Texas Setting Facility Modifier None Typical Low $107.15 Median $162.18 Typical High $954.99 | Facility | None | $107.15 | $162.18 | $954.99 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $346.74 | Professional | None | $194.98 | $245.47 | $346.74 |
Baylor Scott & White Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $724.44 | Professional | None | $204.17 | $316.23 | $724.44 |
Christus Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $162.18 Typical High $239.88 | Facility | None | $66.07 | $162.18 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $316.23 | Professional | None | $199.53 | $239.88 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,621.81 | $1,621.81 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $977.24 Typical High $4,265.80 | Facility | None | $204.17 | $977.24 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $295.12 | Professional | None | $177.83 | $204.17 | $295.12 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $100.00 Typical High $229.09 | Professional | None | $21.88 | $100.00 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $891.25 | Professional | None | $741.31 | $794.33 | $891.25 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $181.97 Typical High $302.00 | Facility | None | $66.07 | $181.97 | $302.00 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $323.59 | Professional | None | $194.98 | $239.88 | $323.59 |
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 $158.49 Median $208.93 Typical High $316.23 | Professional | None | $158.49 | $208.93 | $316.23 |
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 $87.10 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $87.10 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $35.48 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $131.83 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $123.03 | $141.25 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $87.10 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $35.48 | $40.74 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $131.83 | $151.36 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $17.78 | $20.42 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $123.03 | $141.25 | $165.96 |
Where Texas sits
The same service costs 5.1 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· 49th of 51
$186
AK $871UT $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.