How much rates vary
Facilitymedian $182 · 10th to 90th $110 to $2,188Professionalmedian $148 · 10th to 90th $21 to $257
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $229.09 | Professional | None | $138.04 | $162.18 | $229.09 |
BCBS Texas Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $954.99 | Facility | None | $107.15 | $158.49 | $954.99 |
BCBS Texas Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $281.84 | Professional | None | $144.54 | $181.97 | $281.84 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
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 $158.49 Median $194.98 Typical High $257.04 | Professional | None | $158.49 | $194.98 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $977.24 Typical High $4,570.88 | Facility | None | $154.88 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $229.09 | Professional | None | $138.04 | $165.96 | $229.09 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $35.48 Typical High $194.98 | Professional | None | $6.03 | $35.48 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $724.44 | Professional | None | $549.54 | $588.84 | $724.44 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $173.78 Typical High $257.04 | Facility | None | $66.07 | $173.78 | $257.04 |
Providence Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $257.04 | Professional | None | $154.88 | $194.98 | $257.04 |
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 $123.03 Median $162.18 Typical High $245.47 | Professional | None | $123.03 | $162.18 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $63.10 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $63.10 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $38.90 | Professional | 53 · Discontinued | $25.70 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $144.54 | Professional | 54 · Surgery only | $95.50 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $19.50 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $134.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $63.10 | $77.62 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $25.70 | $30.90 | $38.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | 54 · Surgery only | $95.50 | $114.82 | $141.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $22.91 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $22.91 | $28.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $131.83 |
Where Texas sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$148
AK $617FL $135
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.