How much rates vary
Facilitymedian $398 · 10th to 90th $117 to $3,311Professionalmedian $138 · 10th to 90th $25 to $251
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 $173.78 Typical High $204.17 | Professional | None | $107.15 | $173.78 | $204.17 |
BCBS Texas Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $275.42 | Professional | None | $104.71 | $165.96 | $275.42 |
Christus Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $223.87 | Facility | None | $66.07 | $151.36 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $239.88 | Professional | None | $112.20 | $158.49 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $1,000.00 Typical High $4,677.35 | Facility | None | $117.49 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $199.53 | Professional | None | $107.15 | $173.78 | $199.53 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $114.82 Typical High $204.17 | Professional | None | $21.38 | $114.82 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | None | $144.54 | $144.54 | $151.36 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $162.18 Typical High $251.19 | Facility | None | $66.07 | $162.18 | $251.19 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $239.88 | Professional | None | $112.20 | $154.88 | $239.88 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $218.78 | Professional | None | $89.13 | $138.04 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $85.11 Typical High $100.00 | Professional | 52 · Reduced service | $53.70 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $21.38 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $128.82 Typical High $151.36 | Professional | 54 · Surgery only | $79.43 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $16.22 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.98 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.72 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $74.13 | $120.23 | $141.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $53.70 | $83.18 | $100.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $21.38 | $33.11 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $147.91 | Professional | 54 · Surgery only | $79.43 | $125.89 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $25.12 Typical High $30.20 | Professional | 55 · Aftercare only | $16.22 | $25.12 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.72 | $16.60 | $19.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $117.49 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $74.13 | $117.49 | $138.04 |
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· 46th of 51
$138
AK $437NJ $126
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.