How much rates vary
Facilitymedian $240 · 10th to 90th $105 to $2,570Professionalmedian $151 · 10th to 90th $25 to $372
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 $245.47 Median $3,715.35 Typical High $8,709.64 | Facility | None | $245.47 | $3,715.35 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $269.15 | Professional | None | $128.82 | $199.53 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $363.08 | Professional | None | $331.13 | $363.08 | $363.08 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $1,513.56 | Facility | None | $95.50 | $190.55 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $363.08 | Professional | None | $114.82 | $190.55 | $363.08 |
Baylor Scott & White Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $302.00 | Facility | None | $117.49 | $147.91 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $302.00 | Professional | None | $123.03 | $204.17 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,479.11 | $1,479.11 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $338.84 Typical High $4,168.69 | Facility | None | $138.04 | $338.84 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $288.40 | Professional | None | $128.82 | $208.93 | $288.40 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $34.67 Typical High $194.98 | Professional | None | $5.89 | $34.67 | $194.98 |
Providence Setting Facility Modifier None Typical Low $56.23 Median $144.54 Typical High $354.81 | Facility | None | $56.23 | $144.54 | $354.81 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $302.00 | Professional | None | $123.03 | $204.17 | $302.00 |
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 $95.50 Median $162.18 Typical High $281.84 | Professional | None | $95.50 | $162.18 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $63.10 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $63.10 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $95.50 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $93.33 Typical High $123.03 | Professional | 52 · Reduced service | $63.10 | $93.33 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $37.15 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $95.50 | $141.25 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $18.62 | $24.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $173.78 |
Where Texas sits
The same service costs 4.5 times more in Alaska 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
$155
AK $501KY $112
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.