How much rates vary
Facilitymedian $257 · 10th to 90th $115 to $2,884Professionalmedian $186 · 10th to 90th $29 to $309
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 $165.96 Median $199.53 Typical High $257.04 | Professional | None | $165.96 | $199.53 | $257.04 |
BCBS Texas Setting Facility Modifier None Typical Low $104.71 Median $181.97 Typical High $1,174.90 | Facility | None | $104.71 | $181.97 | $1,174.90 |
BCBS Texas Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $331.13 | Professional | None | $190.55 | $239.88 | $331.13 |
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 $181.97 Median $251.19 Typical High $316.23 | Professional | None | $181.97 | $251.19 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,778.28 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $1,000.00 Typical High $4,677.35 | Facility | None | $199.53 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $269.15 | Professional | None | $165.96 | $204.17 | $269.15 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $131.83 Typical High $251.19 | Professional | None | $26.92 | $131.83 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,000.00 | Professional | None | $724.44 | $776.25 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $181.97 Typical High $309.03 | Facility | None | $66.07 | $181.97 | $309.03 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $316.23 | Professional | None | $181.97 | $257.04 | $316.23 |
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 $147.91 Median $194.98 Typical High $302.00 | Professional | None | $147.91 | $194.98 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $83.18 Median $100.00 Typical High $128.82 | Professional | 52 · Reduced service | $83.18 | $100.00 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $51.29 | Professional | 53 · Discontinued | $33.88 | $40.74 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $190.55 | Professional | 54 · Surgery only | $125.89 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $38.02 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $141.25 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $117.49 | $141.25 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $83.18 | $100.00 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $40.74 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $186.21 | Professional | 54 · Surgery only | $125.89 | $151.36 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $25.12 | $30.20 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.60 | $19.95 | $24.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $141.25 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $117.49 | $141.25 | $173.78 |
Where Texas sits
The same service costs 5.0 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· 47th of 51
$186
AK $832FL $166
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.