How much rates vary
Facilitymedian $219 · 10th to 90th $107 to $2,399Professionalmedian $191 · 10th to 90th $28 to $347
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 $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $302.00 | Professional | None | $190.55 | $234.42 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $512.86 | Professional | None | $131.83 | $131.83 | $512.86 |
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 $218.78 Median $275.42 Typical High $407.38 | Professional | None | $218.78 | $275.42 | $407.38 |
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 $66.07 Median $162.18 Typical High $239.88 | Facility | None | $66.07 | $162.18 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $380.19 | Professional | None | $229.09 | $281.84 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,949.84 | $1,949.84 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,174.90 Typical High $6,309.57 | Facility | None | $234.42 | $1,174.90 | $6,309.57 |
Moda Health Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $346.74 | Professional | None | $190.55 | $234.42 | $346.74 |
Molina Setting Professional Modifier None Typical Low $23.44 Median $75.86 Typical High $251.19 | Professional | None | $23.44 | $75.86 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,047.13 | Professional | None | $794.33 | $851.14 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $181.97 Typical High $338.84 | Facility | None | $66.07 | $181.97 | $338.84 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $380.19 | Professional | None | $229.09 | $281.84 | $380.19 |
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 $186.21 Median $245.47 Typical High $371.54 | Professional | None | $186.21 | $245.47 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $95.50 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $144.54 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $95.50 | $117.49 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $46.77 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $144.54 | $173.78 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $28.84 | $34.67 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.05 | $23.44 | $27.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $134.90 | $162.18 | $194.98 |
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
$195
AK $955UT $186
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.