How much rates vary
Facilitymedian $288 · 10th to 90th $126 to $2,291Professionalmedian $132 · 10th to 90th $23 to $275
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 $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $269.15 | Professional | None | $107.15 | $213.80 | $269.15 |
BCBS Texas Setting Facility Modifier None Typical Low $125.89 Median $234.42 Typical High $794.33 | Facility | None | $125.89 | $234.42 | $794.33 |
BCBS Texas Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $426.58 | Professional | None | $109.65 | $208.93 | $426.58 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $1,412.54 | Facility | None | $131.83 | $186.21 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $295.12 | Professional | None | $120.23 | $186.21 | $295.12 |
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 $1,621.81 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,621.81 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $1,000.00 Typical High $4,570.88 | Facility | None | $120.23 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $245.47 | Professional | None | $107.15 | $213.80 | $245.47 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $33.88 Typical High $194.98 | Professional | None | $5.75 | $33.88 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $147.91 | Professional | None | $138.04 | $138.04 | $147.91 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $316.23 Typical High $3,801.89 | Facility | None | $141.25 | $316.23 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $295.12 | Professional | None | $120.23 | $181.97 | $295.12 |
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 $100.00 Median $169.82 Typical High $275.42 | Professional | None | $100.00 | $169.82 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $53.70 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $53.70 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $21.38 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $81.28 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $16.22 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $21.38 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.72 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $75.86 | $147.91 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $53.70 | $104.71 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $21.38 | $41.69 | $47.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $81.28 | $158.49 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $16.22 | $31.62 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.72 | $20.89 | $23.99 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $75.86 | $147.91 | $169.82 |
Where Texas sits
The same service costs 3.5 times more in Alaska 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
$135
AK $468TX $135
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.