How much rates vary
Facilitymedian $1,380 · 10th to 90th $447 to $6,918Professionalmedian $209 · 10th to 90th $31 to $676
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $1,584.89 | Professional | None | $338.84 | $407.38 | $1,584.89 |
BCBS Texas Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $2,570.40 | Facility | None | $407.38 | $758.58 | $2,570.40 |
BCBS Texas Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $1,023.29 | Professional | None | $398.11 | $524.81 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,096.48 Typical High $2,187.76 | Facility | None | $512.86 | $1,096.48 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $676.08 | Professional | None | $407.38 | $426.58 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,388.44 | Professional | None | $3,019.95 | $3,019.95 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $1,905.46 Typical High $5,623.41 | Facility | None | $436.52 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $602.56 | Professional | None | $338.84 | $407.38 | $602.56 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $72.44 Typical High $354.81 | Professional | None | $26.30 | $72.44 | $354.81 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $1,995.26 Typical High $251,188.64 | Facility | None | $512.86 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $426.58 Typical High $676.08 | Professional | None | $389.05 | $426.58 | $676.08 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $660.69 | Professional | None | $323.59 | $436.52 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $169.82 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $51.29 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $239.88 | $263.03 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $190.55 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $75.86 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $302.00 |
Where Texas sits
The same service costs 6.0 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· 50th of 51
$234
AK $1,380UT $229
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.