How much rates vary
Facilitymedian $427 · 10th to 90th $182 to $2,884Professionalmedian $234 · 10th to 90th $36 to $398
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 $331.13 Median $3,715.35 Typical High $9,120.11 | Facility | None | $331.13 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $380.19 | Professional | None | $186.21 | $295.12 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
BCBS Texas Setting Facility Modifier None Typical Low $131.83 Median $309.03 Typical High $1,819.70 | Facility | None | $131.83 | $309.03 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $467.74 | Professional | None | $169.82 | $281.84 | $467.74 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $416.87 Typical High $2,290.87 | Facility | None | $302.00 | $416.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $398.11 | Professional | None | $177.83 | $245.47 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,090.30 | Professional | None | $2,238.72 | $2,238.72 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $707.95 Typical High $5,248.07 | Facility | None | $186.21 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $436.52 | Professional | None | $186.21 | $302.00 | $436.52 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $190.55 Typical High $354.81 | Professional | None | $32.36 | $190.55 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $177.83 | Professional | None | $165.96 | $165.96 | $177.83 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $2,290.87 | Facility | None | $263.03 | $389.05 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $407.38 | Professional | None | $177.83 | $245.47 | $407.38 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,090.30 | Facility | None | $389.05 | $1,288.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $338.84 | Professional | None | $120.23 | $204.17 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
13 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 $93.33 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $93.33 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $60.26 Typical High $72.44 | Professional | 53 · Discontinued | $37.15 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $138.04 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $27.54 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.20 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.62 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $208.93 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $128.82 | $208.93 | $251.19 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 51 · Multiple procedures | $169.82 | $169.82 | $169.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $144.54 Typical High $177.83 | Professional | 52 · Reduced service | $93.33 | $144.54 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $57.54 Typical High $70.79 | Professional | 53 · Discontinued | $37.15 | $57.54 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $218.78 Typical High $269.15 | Professional | 54 · Surgery only | $138.04 | $218.78 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $43.65 Typical High $53.70 | Professional | 55 · Aftercare only | $27.54 | $43.65 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.84 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.62 | $28.84 | $35.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $204.17 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $128.82 | $204.17 | $251.19 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 40th of 51
$234
AK $741KY $166
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.