How much rates vary
Facilitymedian $692 · 10th to 90th $219 to $3,162Professionalmedian $186 · 10th to 90th $27 to $490
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $302.00 | Professional | None | $169.82 | $257.04 | $302.00 |
BCBS Texas Setting Facility Modifier None Typical Low $208.93 Median $323.59 Typical High $1,698.24 | Facility | None | $208.93 | $323.59 | $1,698.24 |
BCBS Texas Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $524.81 | Professional | None | $154.88 | $245.47 | $524.81 |
Christus Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $295.12 Typical High $1,412.54 | Facility | None | $208.93 | $295.12 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $380.19 | Professional | None | $165.96 | $257.04 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $977.24 Typical High $4,570.88 | Facility | None | $173.78 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $302.00 | Professional | None | $169.82 | $257.04 | $302.00 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $37.15 Typical High $229.09 | Professional | None | $5.89 | $37.15 | $229.09 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $3,801.89 | Facility | None | $218.78 | $346.74 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $380.19 | Professional | None | $165.96 | $257.04 | $380.19 |
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 $144.54 Median $223.87 Typical High $354.81 | Professional | None | $144.54 | $223.87 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $85.11 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $85.11 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $33.88 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $125.89 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $43.65 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $117.49 | $173.78 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $83.18 | $123.03 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $33.11 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $123.03 | $186.21 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $43.65 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.60 | $25.12 | $28.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $114.82 | $173.78 | $199.53 |
Where Texas sits
The same service costs 4.3 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· 49th of 51
$209
WI $794KY $186
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.