How much rates vary
Facilitymedian $407 · 10th to 90th $93 to $3,311Professionalmedian $100 · 10th to 90th $16 to $170
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 $85.11 Median $102.33 Typical High $123.03 | Professional | None | $85.11 | $102.33 | $123.03 |
BCBS Texas Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Facility | None | $75.86 | $75.86 | $104.71 |
BCBS Texas Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $181.97 | Professional | None | $100.00 | $123.03 | $181.97 |
Christus Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $151.36 | Facility | None | $66.07 | $104.71 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $169.82 | Professional | None | $102.33 | $128.82 | $169.82 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $1,000.00 Typical High $4,786.30 | Facility | None | $104.71 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $141.25 | Professional | None | $85.11 | $104.71 | $141.25 |
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 $371.54 Median $389.05 Typical High $457.09 | Professional | None | $371.54 | $389.05 | $457.09 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $162.18 | Facility | None | $66.07 | $112.20 | $162.18 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $169.82 | Professional | None | $102.33 | $128.82 | $169.82 |
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 $83.18 Median $107.15 Typical High $162.18 | Professional | None | $83.18 | $107.15 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $41.69 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $16.98 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $63.10 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.51 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $70.79 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $58.88 | $70.79 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $41.69 | $51.29 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $16.98 | $20.42 | $24.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $63.10 | $75.86 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.51 | $10.23 | $12.30 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $70.79 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $58.88 | $70.79 | $85.11 |
Where Texas sits
The same service costs 4.5 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
$102
AK $427FL $95.50
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.