How much rates vary
Facilitymedian $145 · 10th to 90th $81 to $2,188Professionalmedian $102 · 10th to 90th $15 to $186
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 $102.33 Median $112.20 Typical High $154.88 | Professional | None | $102.33 | $112.20 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
BCBS Texas Setting Facility Modifier None Typical Low $77.62 Median $117.49 Typical High $758.58 | Facility | None | $77.62 | $117.49 | $758.58 |
BCBS Texas Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $204.17 | Professional | None | $114.82 | $144.54 | $204.17 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $154.88 | Facility | None | $66.07 | $109.65 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $190.55 | Professional | None | $120.23 | $141.25 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,122.02 | Professional | None | $912.01 | $912.01 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $977.24 Typical High $4,365.16 | Facility | None | $123.03 | $977.24 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $162.18 | Professional | None | $102.33 | $112.20 | $162.18 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $33.11 Typical High $131.83 | Professional | None | $6.03 | $33.11 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $489.78 | Professional | None | $446.68 | $467.74 | $489.78 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $173.78 | Facility | None | $66.07 | $117.49 | $173.78 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $190.55 | Professional | None | $120.23 | $141.25 | $190.55 |
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 $93.33 Median $120.23 Typical High $181.97 | Professional | None | $93.33 | $120.23 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $51.29 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $77.62 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $70.79 | $77.62 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | 52 · Reduced service | $51.29 | $56.23 | $64.57 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.39 Typical High $25.70 | Professional | 53 · Discontinued | $20.42 | $22.39 | $25.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $16.60 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $16.60 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.23 | $11.22 | $12.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $77.62 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $70.79 | $77.62 | $91.20 |
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
$105
AK $501UT $97.72
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.