How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,479 to $9,333Professionalmedian $229 · 10th to 90th $35 to $479
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 $812.83 Median $3,311.31 Typical High $8,511.38 | Facility | None | $812.83 | $3,311.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $416.87 | Professional | None | $281.84 | $295.12 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $331.13 | Professional | None | $229.09 | $251.19 | $331.13 |
BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,786.30 Typical High $12,302.69 | Facility | None | $2,290.87 | $4,786.30 | $12,302.69 |
BCBS Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $436.52 | Professional | None | $213.80 | $239.88 | $436.52 |
Baylor Scott & White Setting Facility Modifier None Typical Low $1,513.56 Median $3,801.89 Typical High $7,585.78 | Facility | None | $1,513.56 | $3,801.89 | $7,585.78 |
Baylor Scott & White Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $371.54 | Professional | None | $302.00 | $302.00 | $371.54 |
Christus Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,467.37 Typical High $4,897.79 | Facility | None | $691.83 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $457.09 | Professional | None | $251.19 | $323.59 | $457.09 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $4,168.69 Typical High $8,709.64 | Facility | None | $537.03 | $4,168.69 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $426.58 | Professional | None | $281.84 | $295.12 | $426.58 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $177.83 Typical High $269.15 | Professional | None | $33.11 | $177.83 | $269.15 |
Oscar Health Setting Facility Modifier None Typical Low $2,818.38 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,818.38 | $3,311.31 | $5,370.32 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $371.54 | Professional | None | $354.81 | $354.81 | $371.54 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $3,548.13 Typical High $6,606.93 | Facility | None | $537.03 | $3,548.13 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $446.68 | Professional | None | $251.19 | $323.59 | $446.68 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,235.94 | $6,918.31 |
United Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $436.52 | Professional | None | $223.87 | $295.12 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $141.25 Median $147.91 Typical High $173.78 | Professional | 52 · Reduced service | $141.25 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $208.93 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $147.91 Typical High $158.49 | Professional | 52 · Reduced service | $141.25 | $147.91 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $60.26 | $64.57 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $223.87 Typical High $239.88 | Professional | 54 · Surgery only | $208.93 | $223.87 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $44.67 Typical High $47.86 | Professional | 55 · Aftercare only | $41.69 | $44.67 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $29.51 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $29.51 | $32.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $194.98 | $208.93 | $223.87 |
Where Texas sits
The same service costs 5.5 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· 50th of 51
$240
AK $1,202UT $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.