How much rates vary
Facilitymedian $759 · 10th to 90th $224 to $3,548Professionalmedian $234 · 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 $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 $204.17 Median $302.00 Typical High $371.54 | Professional | None | $204.17 | $302.00 | $371.54 |
BCBS Texas Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $2,238.72 | Facility | None | $467.74 | $812.83 | $2,238.72 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $562.34 | Professional | None | $194.98 | $281.84 | $562.34 |
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 $302.00 Median $398.11 Typical High $1,412.54 | Facility | None | $302.00 | $398.11 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $478.63 | Professional | None | $208.93 | $309.03 | $478.63 |
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 $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $977.24 Typical High $4,570.88 | Facility | None | $229.09 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $407.38 | Professional | None | $204.17 | $302.00 | $407.38 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $169.82 Typical High $309.03 | Professional | None | $31.62 | $169.82 | $309.03 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $3,801.89 | Facility | None | $302.00 | $457.09 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $478.63 | Professional | None | $208.93 | $309.03 | $478.63 |
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 $190.55 Median $295.12 Typical High $467.74 | Professional | None | $190.55 | $295.12 | $467.74 |
Wellpoint Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $102.33 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $102.33 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $40.74 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $151.36 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $30.90 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.42 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $141.25 | $204.17 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $102.33 | $147.91 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $40.74 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $151.36 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $44.67 Typical High $51.29 | Professional | 55 · Aftercare only | $30.20 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.42 | $29.51 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $141.25 | $208.93 | $234.42 |
Where Texas sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 51st of 51
$251
WI $933TX $251
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.