How much rates vary
Facilitymedian $1,738 · 10th to 90th $646 to $4,169Professionalmedian $219 · 10th to 90th $27 to $389
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 $660.69 Median $2,630.27 Typical High $6,918.31 | Facility | None | $660.69 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $426.58 | Professional | None | $218.78 | $302.00 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
BCBS Texas Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $3,890.45 | Facility | None | $933.25 | $1,862.09 | $3,890.45 |
BCBS Texas Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $407.38 | Professional | None | $208.93 | $288.40 | $407.38 |
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 $588.84 Median $851.14 Typical High $1,862.09 | Facility | None | $588.84 | $851.14 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $407.38 | Professional | None | $234.42 | $302.00 | $407.38 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,630.27 | Professional | None | $2,187.76 | $2,187.76 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,174.90 Typical High $4,786.30 | Facility | None | $234.42 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $426.58 | Professional | None | $218.78 | $302.00 | $426.58 |
Molina Setting Professional Modifier None Typical Low $5.75 Median $42.66 Typical High $257.04 | Professional | None | $5.75 | $42.66 | $257.04 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | None | $288.40 | $288.40 | $302.00 |
Providence Setting Facility Modifier None Typical Low $331.13 Median $912.01 Typical High $4,466.84 | Facility | None | $331.13 | $912.01 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $407.38 | Professional | None | $234.42 | $302.00 | $407.38 |
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 $186.21 Median $263.03 Typical High $398.11 | Professional | None | $186.21 | $263.03 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $109.65 Median $147.91 Typical High $169.82 | Professional | 52 · Reduced service | $109.65 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $165.96 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $29.51 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $147.91 Typical High $165.96 | Professional | 52 · Reduced service | $109.65 | $147.91 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $43.65 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $223.87 Typical High $251.19 | Professional | 54 · Surgery only | $165.96 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $44.67 Typical High $50.12 | Professional | 55 · Aftercare only | $33.11 | $44.67 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $29.51 Typical High $33.88 | Professional | 56 · Pre-op care only | $21.88 | $29.51 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $208.93 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $154.88 | $208.93 | $234.42 |
Where Texas sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$229
AK $933UT $219
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.