How much rates vary
Facilitymedian $427 · 10th to 90th $158 to $3,311Professionalmedian $174 · 10th to 90th $30 to $676
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 $120.23 Median $204.17 Typical High $269.15 | Professional | None | $120.23 | $204.17 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
BCBS Texas Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $1,412.54 | Facility | None | $158.49 | $234.42 | $1,412.54 |
BCBS Texas Setting Professional Modifier None Typical Low $117.49 Median $194.98 Typical High $354.81 | Professional | None | $117.49 | $194.98 | $354.81 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $2,290.87 | Facility | None | $169.82 | $239.88 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $302.00 | Professional | None | $125.89 | $213.80 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $1,096.48 Typical High $4,677.35 | Facility | None | $131.83 | $1,096.48 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $302.00 | Professional | None | $120.23 | $208.93 | $302.00 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $144.54 Typical High $204.17 | Professional | None | $26.30 | $144.54 | $204.17 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $229.09 Typical High $2,290.87 | Facility | None | $162.18 | $229.09 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $309.03 | Professional | None | $125.89 | $213.80 | $309.03 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,890.45 | Facility | None | $616.60 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $281.84 | Professional | None | $107.15 | $173.78 | $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 $60.26 Median $100.00 Typical High $117.49 | Professional | 52 · Reduced service | $60.26 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $23.99 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $89.13 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $18.20 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.02 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $85.11 | $141.25 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $60.26 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $23.99 | $40.74 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $89.13 | $151.36 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $17.78 | $30.90 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.02 | $20.42 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $83.18 | $141.25 | $165.96 |
Where Texas sits
The same service costs 3.8 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· 48th of 51
$186
WI $631KY $166
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.