How much rates vary
Facilitymedian $501 · 10th to 90th $162 to $3,236Professionalmedian $141 · 10th to 90th $25 to $245
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 $6,760.83 | Facility | None | $575.44 | $2,238.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $162.18 | Professional | None | $114.82 | $138.04 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $234.42 Median $436.52 Typical High $1,862.09 | Facility | None | $234.42 | $436.52 | $1,862.09 |
BCBS Texas Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $234.42 | Professional | None | $117.49 | $147.91 | $234.42 |
Christus Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $218.78 Typical High $1,412.54 | Facility | None | $154.88 | $218.78 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | None | $131.83 | $162.18 | $223.87 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $1,000.00 Typical High $4,570.88 | Facility | None | $134.90 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | None | $114.82 | $138.04 | $190.55 |
Molina Setting Professional Modifier None Typical Low $22.39 Median $125.89 Typical High $173.78 | Professional | None | $22.39 | $125.89 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $575.44 | Professional | None | $426.58 | $537.03 | $575.44 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $302.00 Typical High $3,801.89 | Facility | None | $154.88 | $302.00 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | None | $131.83 | $162.18 | $223.87 |
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 $107.15 Median $144.54 Typical High $213.80 | Professional | None | $107.15 | $144.54 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $53.70 Median $64.57 Typical High $81.28 | Professional | 52 · Reduced service | $53.70 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $21.38 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $91.20 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $74.13 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $64.57 Typical High $79.43 | Professional | 52 · Reduced service | $53.70 | $64.57 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $21.38 | $25.70 | $32.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $97.72 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $97.72 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $16.22 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $91.20 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $74.13 | $91.20 | $112.20 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Delaware. 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· 45th of 51
$145
AK $513DE $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.