How much rates vary
Facilitymedian $195 · 10th to 90th $81 to $3,631Professionalmedian $110 · 10th to 90th $19 to $891
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 $134.90 Median $3,715.35 Typical High $9,120.11 | Facility | None | $134.90 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $138.04 | Professional | None | $79.43 | $109.65 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $831.76 | Facility | None | $67.61 | $117.49 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $186.21 | Professional | None | $85.11 | $114.82 | $186.21 |
Christus Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $1,412.54 | Facility | None | $81.28 | $114.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $177.83 | Professional | None | $91.20 | $120.23 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | None | $891.25 | $891.25 | $1,047.13 |
Moda Health Setting Facility Modifier None Typical Low $83.18 Median $707.95 Typical High $5,248.07 | Facility | None | $83.18 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $158.49 | Professional | None | $79.43 | $109.65 | $158.49 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $151.36 Typical High $3,801.89 | Facility | None | $89.13 | $151.36 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $177.83 | Professional | None | $91.20 | $120.23 | $177.83 |
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 $70.79 Median $102.33 Typical High $158.49 | Professional | None | $70.79 | $102.33 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $39.81 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $39.81 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $15.85 | $20.89 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $77.62 Typical High $100.00 | Professional | 54 · Surgery only | $60.26 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.85 Typical High $19.95 | Professional | 55 · Aftercare only | $12.02 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $72.44 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $56.23 | $72.44 | $93.33 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $117.49 Median $117.49 Typical High $123.03 | Professional | 58 · Staged procedure | $117.49 | $117.49 | $123.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $39.81 | $52.48 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $15.85 | $20.89 | $26.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $77.62 Typical High $100.00 | Professional | 54 · Surgery only | $60.26 | $77.62 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $15.85 Typical High $19.95 | Professional | 55 · Aftercare only | $12.02 | $15.85 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $7.94 | $10.47 | $13.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $72.44 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $56.23 | $72.44 | $93.33 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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· 46th of 51
$112
AK $355PA $107
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.