How much rates vary
Facilitymedian $589 · 10th to 90th $269 to $2,754Professionalmedian $229 · 10th to 90th $35 to $513
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $323.59 | Professional | None | $194.98 | $281.84 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
BCBS Texas Setting Facility Modifier None Typical Low $302.00 Median $549.54 Typical High $1,698.24 | Facility | None | $302.00 | $549.54 | $1,698.24 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $691.83 | Professional | None | $194.98 | $302.00 | $691.83 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $1,862.09 | Facility | None | $288.40 | $416.87 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $446.68 | Professional | None | $208.93 | $295.12 | $446.68 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,137.96 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $1,174.90 Typical High $4,786.30 | Facility | None | $218.78 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $323.59 | Professional | None | $194.98 | $281.84 | $323.59 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $169.82 Typical High $295.12 | Professional | None | $31.62 | $169.82 | $295.12 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $489.78 Typical High $4,466.84 | Facility | None | $295.12 | $489.78 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $446.68 | Professional | None | $208.93 | $295.12 | $446.68 |
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 $181.97 Median $269.15 Typical High $416.87 | Professional | None | $181.97 | $269.15 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $95.50 Median $138.04 Typical High $162.18 | Professional | 52 · Reduced service | $95.50 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $54.95 Typical High $64.57 | Professional | 53 · Discontinued | $38.90 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $144.54 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $28.84 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $141.25 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $56.23 Typical High $63.10 | Professional | 53 · Discontinued | $38.02 | $56.23 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $208.93 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $208.93 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $41.69 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $28.18 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $194.98 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $194.98 | $218.78 |
Where Texas sits
The same service costs 3.7 times more in Wisconsin than in Utah. 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
$257
WI $891UT $240
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.