How much rates vary
Facilitymedian $1,380 · 10th to 90th $617 to $3,890Professionalmedian $219 · 10th to 90th $27 to $562
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 $524.81 Median $2,187.76 Typical High $6,760.83 | Facility | None | $524.81 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $389.05 | Professional | None | $194.98 | $269.15 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $3,715.35 | Facility | None | $660.69 | $1,412.54 | $3,715.35 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $524.81 | Professional | None | $194.98 | $275.42 | $524.81 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $1,584.89 | Facility | None | $457.09 | $831.76 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $436.52 | Professional | None | $208.93 | $281.84 | $436.52 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $1,000.00 Typical High $4,897.79 | Facility | None | $239.88 | $1,000.00 | $4,897.79 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $380.19 | Professional | None | $194.98 | $269.15 | $380.19 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $42.66 Typical High $263.03 | Professional | None | $5.89 | $42.66 | $263.03 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $870.96 Typical High $3,801.89 | Facility | None | $309.03 | $870.96 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $436.52 | Professional | None | $208.93 | $281.84 | $436.52 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $416.87 | Professional | None | $190.55 | $275.42 | $416.87 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $97.72 Median $131.83 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $52.48 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $147.91 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $39.81 Typical High $44.67 | Professional | 55 · Aftercare only | $29.51 | $39.81 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $138.04 | $186.21 | $208.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $131.83 Typical High $147.91 | Professional | 52 · Reduced service | $97.72 | $131.83 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $52.48 Typical High $58.88 | Professional | 53 · Discontinued | $38.90 | $52.48 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $199.53 Typical High $218.78 | Professional | 54 · Surgery only | $144.54 | $199.53 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $39.81 Typical High $43.65 | Professional | 55 · Aftercare only | $28.84 | $39.81 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $26.30 Typical High $29.51 | Professional | 56 · Pre-op care only | $19.50 | $26.30 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $186.21 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $134.90 | $186.21 | $204.17 |
Where Texas sits
The same service costs 4.3 times more in Alaska 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· 50th of 51
$251
AK $1,000UT $234
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.