How much rates vary
Facilitymedian $562 · 10th to 90th $126 to $3,388Professionalmedian $135 · 10th to 90th $23 to $263
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 $676.08 Median $2,570.40 Typical High $6,918.31 | Facility | None | $676.08 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $263.03 | Professional | None | $107.15 | $177.83 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $1,023.29 | Facility | None | $117.49 | $173.78 | $1,023.29 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $295.12 | Professional | None | $102.33 | $169.82 | $295.12 |
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 $134.90 Median $194.98 Typical High $1,862.09 | Facility | None | $134.90 | $194.98 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $245.47 | Professional | None | $112.20 | $162.18 | $245.47 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,348.96 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $1,174.90 Typical High $4,786.30 | Facility | None | $120.23 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $263.03 | Professional | None | $107.15 | $177.83 | $263.03 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $114.82 Typical High $169.82 | Professional | None | $21.38 | $114.82 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | None | $162.18 | $162.18 | $173.78 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $251.19 Typical High $4,466.84 | Facility | None | $144.54 | $251.19 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $245.47 | Professional | None | $112.20 | $162.18 | $245.47 |
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 $89.13 Median $144.54 Typical High $223.87 | Professional | None | $89.13 | $144.54 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $53.70 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $36.31 Typical High $42.66 | Professional | 53 · Discontinued | $21.38 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $81.28 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $16.22 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $10.72 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $75.86 | $125.89 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $53.70 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $21.38 | $35.48 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $131.83 Typical High $158.49 | Professional | 54 · Surgery only | $81.28 | $131.83 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.30 Typical High $31.62 | Professional | 55 · Aftercare only | $16.22 | $26.30 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.72 | $17.78 | $20.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $75.86 Median $123.03 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $75.86 | $123.03 | $147.91 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 46th of 51
$138
AK $447FL $132
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.