How much rates vary
Facilitymedian $204 · 10th to 90th $95 to $2,399Professionalmedian $331 · 10th to 90th $49 to $631
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 $645.65 Median $2,398.83 Typical High $6,918.31 | Facility | None | $645.65 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $575.44 | Professional | None | $398.11 | $426.58 | $575.44 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $147.91 Typical High $912.01 | Facility | None | $95.50 | $147.91 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $645.65 | Professional | None | $380.19 | $478.63 | $645.65 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $158.49 Typical High $245.47 | Facility | None | $66.07 | $158.49 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $616.60 | Professional | None | $354.81 | $457.09 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,090.30 | Professional | None | $3,019.95 | $3,019.95 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $1,737.80 Typical High $5,248.07 | Facility | None | $398.11 | $1,737.80 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $501.19 | Professional | None | $398.11 | $426.58 | $501.19 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $269.15 Typical High $380.19 | Professional | None | $45.71 | $269.15 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | None | $389.05 | $389.05 | $407.38 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $169.82 Typical High $436.52 | Facility | None | $66.07 | $169.82 | $436.52 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $602.56 | Professional | None | $331.13 | $457.09 | $602.56 |
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 $316.23 Median $416.87 Typical High $602.56 | Professional | None | $316.23 | $416.87 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $199.53 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $371.54 | Professional | 54 · Surgery only | $295.12 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $213.80 Typical High $229.09 | Professional | 52 · Reduced service | $199.53 | $213.80 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $79.43 | $85.11 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $316.23 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $63.10 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $63.10 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $45.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $275.42 | $295.12 | $316.23 |
Where Texas sits
The same service costs 4.2 times more in Wyoming 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· 49th of 51
$331
WY $1,288UT $309
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.