How much rates vary
Facilitymedian $457 · 10th to 90th $162 to $3,548Professionalmedian $170 · 10th to 90th $30 to $288
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 $141.25 Median $229.09 Typical High $275.42 | Professional | None | $141.25 | $229.09 | $275.42 |
BCBS Texas Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $1,479.11 | Facility | None | $154.88 | $245.47 | $1,479.11 |
BCBS Texas Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $512.86 | Professional | None | $128.82 | $213.80 | $512.86 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $1,412.54 | Facility | None | $169.82 | $239.88 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $316.23 | Professional | None | $144.54 | $208.93 | $316.23 |
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 $147.91 Median $1,000.00 Typical High $4,677.35 | Facility | None | $147.91 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $269.15 | Professional | None | $141.25 | $229.09 | $269.15 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $151.36 Typical High $229.09 | Professional | None | $27.54 | $151.36 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | None | $213.80 | $213.80 | $223.87 |
Providence Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $3,801.89 | Facility | None | $177.83 | $323.59 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $316.23 | Professional | None | $144.54 | $208.93 | $316.23 |
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 $120.23 Median $194.98 Typical High $302.00 | Professional | None | $120.23 | $194.98 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $69.18 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $69.18 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $28.18 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $34.67 Typical High $39.81 | Professional | 55 · Aftercare only | $20.89 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.13 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $97.72 | $158.49 | $181.97 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $109.65 Typical High $131.83 | Professional | 52 · Reduced service | $69.18 | $109.65 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $43.65 Typical High $52.48 | Professional | 53 · Discontinued | $28.18 | $43.65 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $165.96 Typical High $194.98 | Professional | 54 · Surgery only | $104.71 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $38.90 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $21.88 Typical High $26.30 | Professional | 56 · Pre-op care only | $14.13 | $21.88 | $26.30 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $154.88 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $97.72 | $154.88 | $181.97 |
Where Texas sits
The same service costs 3.5 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
$174
AK $575NJ $166
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.