How much rates vary
Facilitymedian $288 · 10th to 90th $102 to $3,162Professionalmedian $138 · 10th to 90th $28 to $603
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 $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $151.36 Typical High $234.42 | Professional | None | $61.66 | $151.36 | $234.42 |
BCBS Texas Setting Facility Modifier None Typical Low $89.13 Median $158.49 Typical High $977.24 | Facility | None | $89.13 | $158.49 | $977.24 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $138.04 Typical High $239.88 | Professional | None | $58.88 | $138.04 | $239.88 |
Christus Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $2,290.87 | Facility | None | $147.91 | $208.93 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $213.80 | Professional | None | $67.61 | $131.83 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $1,000.00 Typical High $4,677.35 | Facility | None | $87.10 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $141.25 Typical High $234.42 | Professional | None | $61.66 | $141.25 | $234.42 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $131.83 Typical High $177.83 | Professional | None | $23.99 | $131.83 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $676.08 | Professional | None | $177.83 | $229.09 | $676.08 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $194.98 Typical High $2,290.87 | Facility | None | $120.23 | $194.98 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $213.80 | Professional | None | $67.61 | $131.83 | $213.80 |
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 $53.70 Median $107.15 Typical High $181.97 | Professional | None | $53.70 | $107.15 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
11 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 $30.20 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $30.20 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $12.30 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $117.49 Typical High $144.54 | Professional | 54 · Surgery only | $45.71 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $9.12 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.17 | $15.85 | $19.05 |
Ambetter Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $60.26 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $60.26 | $60.26 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $75.86 Typical High $95.50 | Professional | 52 · Reduced service | $30.20 | $75.86 | $95.50 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $12.30 | $30.90 | $38.02 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $114.82 Typical High $144.54 | Professional | 54 · Surgery only | $45.71 | $114.82 | $144.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $9.12 | $22.91 | $28.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.17 | $15.49 | $19.05 |
Where Texas sits
The same service costs 3.7 times more in Alaska than in Washington, DC. 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· 29th of 51
$141
AK $309DC $83.18
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.