How much rates vary
Facilitymedian $589 · 10th to 90th $162 to $3,162Professionalmedian $155 · 10th to 90th $28 to $269
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $302.00 | Professional | None | $128.82 | $218.78 | $302.00 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Professional | None | $114.82 | $114.82 | $218.78 |
BCBS Texas Setting Facility Modifier None Typical Low $154.88 Median $229.09 Typical High $1,348.96 | Facility | None | $154.88 | $229.09 | $1,348.96 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $281.84 | Professional | None | $120.23 | $204.17 | $281.84 |
Christus Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $245.47 Typical High $1,412.54 | Facility | None | $173.78 | $245.47 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | None | $131.83 | $194.98 | $295.12 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $977.24 Typical High $5,128.61 | Facility | None | $138.04 | $977.24 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $295.12 | Professional | None | $128.82 | $213.80 | $295.12 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $44.67 Typical High $218.78 | Professional | None | $25.70 | $44.67 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $204.17 | Professional | None | $190.55 | $190.55 | $204.17 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $309.03 Typical High $3,801.89 | Facility | None | $181.97 | $309.03 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $295.12 | Professional | None | $131.83 | $194.98 | $295.12 |
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 $107.15 Median $173.78 Typical High $275.42 | Professional | None | $107.15 | $173.78 | $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 $63.10 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $63.10 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $43.65 Typical High $52.48 | Professional | 53 · Discontinued | $25.70 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.88 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $89.13 | $154.88 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $63.10 | $107.15 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $25.70 | $43.65 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $162.18 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $162.18 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $32.36 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $21.88 | $25.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $151.36 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $89.13 | $151.36 | $181.97 |
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
$158
AK $525DC $158
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.