How much rates vary
Facilitymedian $1,380 · 10th to 90th $603 to $3,890Professionalmedian $135 · 10th to 90th $25 to $257
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 $107.15 Median $204.17 Typical High $288.40 | Professional | None | $107.15 | $204.17 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $186.21 | Professional | None | $128.82 | $128.82 | $186.21 |
BCBS Texas Setting Facility Modifier None Typical Low $660.69 Median $1,380.38 Typical High $3,715.35 | Facility | None | $660.69 | $1,380.38 | $3,715.35 |
BCBS Texas Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $269.15 | Professional | None | $91.20 | $173.78 | $269.15 |
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 $112.20 Median $165.96 Typical High $281.84 | Professional | None | $112.20 | $165.96 | $281.84 |
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 $1,513.56 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,513.56 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $1,071.52 Typical High $5,495.41 | Facility | None | $141.25 | $1,071.52 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $302.00 | Professional | None | $107.15 | $204.17 | $302.00 |
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 $154.88 Median $154.88 Typical High $162.18 | Professional | None | $154.88 | $154.88 | $162.18 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $870.96 Typical High $3,801.89 | Facility | None | $213.80 | $870.96 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $281.84 | Professional | None | $112.20 | $165.96 | $281.84 |
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 $89.13 Median $162.18 Typical High $257.04 | Professional | None | $89.13 | $162.18 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
13 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 $125.89 | Professional | 52 · Reduced service | $53.70 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $21.88 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $81.28 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $16.22 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.72 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $75.86 | $144.54 | $173.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $53.70 | $102.33 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $21.88 | $41.69 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $81.28 | $154.88 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $16.22 | $30.90 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.72 | $20.42 | $24.55 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $181.97 Median $181.97 Typical High $234.42 | Professional | 59 · Distinct service | $181.97 | $181.97 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $75.86 | $144.54 | $173.78 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$138
AK $447DC $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.