How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,096 to $6,026Professionalmedian $191 · 10th to 90th $31 to $309
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 $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $346.74 | Professional | None | $173.78 | $229.09 | $346.74 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $2,630.27 Typical High $6,760.83 | Facility | None | $1,258.93 | $2,630.27 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $389.05 | Professional | None | $177.83 | $239.88 | $389.05 |
Christus Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $2,818.38 | Facility | None | $457.09 | $1,995.26 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $346.74 | Professional | None | $186.21 | $245.47 | $346.74 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $218.78 Median $1,202.26 Typical High $4,365.16 | Facility | None | $218.78 | $1,202.26 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $346.74 | Professional | None | $173.78 | $234.42 | $346.74 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $154.88 Typical High $229.09 | Professional | None | $28.18 | $154.88 | $229.09 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $1,905.46 Typical High $3,801.89 | Facility | None | $269.15 | $1,905.46 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $346.74 | Professional | None | $186.21 | $245.47 | $346.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $309.03 | Professional | None | $151.36 | $204.17 | $309.03 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $87.10 Median $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $109.65 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $43.65 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $162.18 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $162.18 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $32.36 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $32.36 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $151.36 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $123.03 | $151.36 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $109.65 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $109.65 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $43.65 Typical High $58.88 | Professional | 53 · Discontinued | $34.67 | $43.65 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $131.83 | $165.96 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $26.30 | $33.11 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $21.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $17.38 | $21.88 | $29.51 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $123.03 | $154.88 | $204.17 |
Where Texas sits
The same service costs 4.4 times more in Alaska than in Utah. 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· 49th of 51
$219
AK $871UT $200
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.