How much rates vary
Facilitymedian $257 · 10th to 90th $107 to $2,188Professionalmedian $170 · 10th to 90th $27 to $437
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 $120.23 Median $251.19 Typical High $363.08 | Professional | None | $120.23 | $251.19 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $912.01 | Facility | None | $95.50 | $154.88 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $436.52 | Professional | None | $117.49 | $239.88 | $436.52 |
Christus Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $154.88 Typical High $229.09 | Facility | None | $66.07 | $154.88 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $354.81 | Professional | None | $125.89 | $239.88 | $354.81 |
Lucent Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,905.46 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $977.24 Typical High $4,570.88 | Facility | None | $134.90 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $354.81 | Professional | None | $120.23 | $251.19 | $354.81 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $37.15 Typical High $229.09 | Professional | None | $5.89 | $37.15 | $229.09 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $316.23 | Facility | None | $66.07 | $165.96 | $316.23 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $354.81 | Professional | None | $125.89 | $239.88 | $354.81 |
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 $100.00 Median $190.55 Typical High $316.23 | Professional | None | $100.00 | $190.55 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $60.26 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $60.26 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $24.55 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $91.20 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $18.20 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $12.02 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $85.11 | $165.96 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $60.26 | $120.23 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $24.55 | $47.86 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $91.20 | $177.83 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $18.20 | $35.48 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $12.02 | $23.99 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $165.96 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $85.11 | $165.96 | $218.78 |
Where Texas sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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
$174
WI $490KY $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.