How much rates vary
Facilitymedian $1,380 · 10th to 90th $631 to $3,890Professionalmedian $170 · 10th to 90th $28 to $309
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 $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $245.47 | Professional | None | $151.36 | $208.93 | $245.47 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $3,715.35 | Facility | None | $691.83 | $1,412.54 | $3,715.35 |
BCBS Texas Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $331.13 | Professional | None | $147.91 | $204.17 | $331.13 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $1,584.89 | Facility | None | $457.09 | $831.76 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $288.40 | Professional | None | $158.49 | $208.93 | $288.40 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,548.82 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $158.49 Median $1,000.00 Typical High $4,786.30 | Facility | None | $158.49 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $239.88 | Professional | None | $151.36 | $208.93 | $239.88 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $144.54 Typical High $208.93 | Professional | None | $26.92 | $144.54 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $199.53 | Professional | None | $190.55 | $190.55 | $199.53 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $870.96 Typical High $3,801.89 | Facility | None | $223.87 | $870.96 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $288.40 | Professional | None | $158.49 | $208.93 | $288.40 |
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 $125.89 Median $181.97 Typical High $281.84 | Professional | None | $125.89 | $181.97 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $75.86 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $158.49 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $147.91 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $147.91 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $75.86 | $104.71 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $30.20 | $41.69 | $47.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $114.82 | $154.88 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $31.62 Typical High $36.31 | Professional | 55 · Aftercare only | $22.91 | $31.62 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $15.14 | $20.89 | $23.99 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $107.15 | $144.54 | $169.82 |
Where Texas sits
The same service costs 4.2 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· 48th of 51
$174
AK $646NJ $155
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.