How much rates vary
Facilitymedian $195 · 10th to 90th $100 to $2,291Professionalmedian $141 · 10th to 90th $24 to $1,318
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $245.47 | Professional | None | $109.65 | $173.78 | $245.47 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $912.01 | Facility | None | $95.50 | $151.36 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $288.40 | Professional | None | $102.33 | $169.82 | $288.40 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
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 $112.20 Median $181.97 Typical High $263.03 | Professional | None | $112.20 | $181.97 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $1,000.00 Typical High $4,570.88 | Facility | None | $120.23 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $245.47 | Professional | None | $109.65 | $173.78 | $245.47 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $114.82 Typical High $169.82 | Professional | None | $21.38 | $114.82 | $169.82 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $165.96 Typical High $263.03 | Facility | None | $66.07 | $165.96 | $263.03 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $181.97 Typical High $269.15 | Professional | None | $112.20 | $181.97 | $269.15 |
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 $89.13 Median $147.91 Typical High $245.47 | Professional | None | $89.13 | $147.91 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $54.95 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $54.95 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $21.88 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $32.36 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $54.95 | $81.28 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $21.88 | $32.36 | $42.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $83.18 | $120.23 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $32.36 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $21.38 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $147.91 |
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
$148
AK $457KY $102
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.