How much rates vary
Facilitymedian $263 · 10th to 90th $135 to $2,692Professionalmedian $129 · 10th to 90th $20 to $437
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 $102.33 Median $134.90 Typical High $165.96 | Professional | None | $102.33 | $134.90 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $141.25 | Professional | None | $117.49 | $138.04 | $141.25 |
BCBS Texas Setting Facility Modifier None Typical Low $165.96 Median $316.23 Typical High $1,096.48 | Facility | None | $165.96 | $316.23 | $1,096.48 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $275.42 | Professional | None | $107.15 | $144.54 | $275.42 |
Christus Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
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 $117.49 Median $151.36 Typical High $223.87 | Professional | None | $117.49 | $151.36 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,071.52 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $645.65 Typical High $5,248.07 | Facility | None | $107.15 | $645.65 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $181.97 | Professional | None | $102.33 | $134.90 | $181.97 |
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 $58.88 Median $134.90 Typical High $275.42 | Facility | None | $58.88 | $134.90 | $275.42 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $223.87 | Professional | None | $117.49 | $151.36 | $223.87 |
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 $89.13 Median $128.82 Typical High $194.98 | Professional | None | $89.13 | $128.82 | $194.98 |
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 $51.29 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $51.29 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $25.70 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $77.62 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $91.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $72.44 | $91.20 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $64.57 Typical High $83.18 | Professional | 52 · Reduced service | $51.29 | $64.57 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $33.11 | Professional | 53 · Discontinued | $20.42 | $25.70 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $97.72 Typical High $125.89 | Professional | 54 · Surgery only | $77.62 | $97.72 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $25.12 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $16.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $91.20 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $72.44 | $91.20 | $117.49 |
Where Texas sits
The same service costs 4.1 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· 45th of 51
$135
AK $457KY $112
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.