How much rates vary
Facilitymedian $575 · 10th to 90th $123 to $3,631Professionalmedian $120 · 10th to 90th $19 to $1,047
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 $165.96 Median $3,715.35 Typical High $9,120.11 | Facility | None | $165.96 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $165.96 | Professional | None | $97.72 | $134.90 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
BCBS Texas Setting Facility Modifier None Typical Low $288.40 Median $549.54 Typical High $2,818.38 | Facility | None | $288.40 | $549.54 | $2,818.38 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $229.09 | Professional | None | $102.33 | $141.25 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $208.93 | Professional | None | $112.20 | $151.36 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $707.95 Typical High $5,248.07 | Facility | None | $95.50 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $177.83 | Professional | None | $97.72 | $134.90 | $177.83 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $87.10 Typical High $134.90 | Professional | None | $16.22 | $87.10 | $134.90 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $128.82 Typical High $269.15 | Facility | None | $50.12 | $128.82 | $269.15 |
Providence Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $208.93 | Professional | None | $112.20 | $151.36 | $208.93 |
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 $87.10 Median $123.03 Typical High $186.21 | Professional | None | $87.10 | $123.03 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $48.98 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $48.98 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $19.50 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $97.72 Typical High $123.03 | Professional | 54 · Surgery only | $74.13 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $14.79 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.77 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $91.20 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $69.18 | $91.20 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $48.98 | $64.57 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $19.50 | $25.70 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $97.72 Typical High $123.03 | Professional | 54 · Surgery only | $74.13 | $97.72 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $19.50 Typical High $24.55 | Professional | 55 · Aftercare only | $14.79 | $19.50 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.77 | $12.88 | $16.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $91.20 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $69.18 | $91.20 | $114.82 |
Where Texas sits
The same service costs 4.2 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· 48th of 51
$129
AK $437KY $105
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.