How much rates vary
Facilitymedian $200 · 10th to 90th $44 to $3,162Professionalmedian $115 · 10th to 90th $18 to $214
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 $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $204.17 | Professional | None | $107.15 | $147.91 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $144.54 Typical High $144.54 | Professional | None | $48.98 | $144.54 | $144.54 |
BCBS Texas Setting Facility Modifier None Typical Low $93.33 Median $144.54 Typical High $891.25 | Facility | None | $93.33 | $144.54 | $891.25 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $239.88 | Professional | None | $102.33 | $141.25 | $239.88 |
Christus Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $141.25 Typical High $1,412.54 | Facility | None | $102.33 | $141.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $204.17 | Professional | None | $112.20 | $147.91 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | None | $1,047.13 | $1,047.13 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $977.24 Typical High $4,570.88 | Facility | None | $117.49 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $194.98 | Professional | None | $107.15 | $147.91 | $194.98 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $87.10 Typical High $134.90 | Professional | None | $16.22 | $87.10 | $134.90 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | None | $151.36 | $151.36 | $162.18 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $3,801.89 | Facility | None | $112.20 | $199.53 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $199.53 | Professional | None | $112.20 | $147.91 | $199.53 |
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 $128.82 Typical High $194.98 | Professional | None | $89.13 | $128.82 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $72.44 Typical High $83.18 | Professional | 52 · Reduced service | $53.70 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $21.38 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $79.43 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $100.00 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $74.13 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $72.44 Typical High $81.28 | Professional | 52 · Reduced service | $53.70 | $72.44 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $33.11 | Professional | 53 · Discontinued | $21.38 | $28.84 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $123.03 | Professional | 54 · Surgery only | $79.43 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $24.55 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $16.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $100.00 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $74.13 | $100.00 | $114.82 |
Where Texas sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 49th of 51
$115
AK $437NJ $110
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.