How much rates vary
Facilitymedian $145 · 10th to 90th $79 to $2,291Professionalmedian $120 · 10th to 90th $19 to $240
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 $512.86 Median $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $186.21 | Professional | None | $100.00 | $123.03 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | None | $134.90 | $134.90 | $147.91 |
BCBS Texas Setting Facility Modifier None Typical Low $72.44 Median $107.15 Typical High $707.95 | Facility | None | $72.44 | $107.15 | $707.95 |
BCBS Texas Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $223.87 | Professional | None | $109.65 | $144.54 | $223.87 |
Baylor Scott & White Setting Facility Modifier None Typical Low $112.20 Median $309.03 Typical High $562.34 | Facility | None | $112.20 | $309.03 | $562.34 |
Christus Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $1,412.54 | Facility | None | $87.10 | $123.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $218.78 | Professional | None | $120.23 | $151.36 | $218.78 |
Lucent Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,584.89 | $1,737.80 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $1,000.00 Typical High $6,918.31 | Facility | None | $125.89 | $1,000.00 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $186.21 | Professional | None | $100.00 | $123.03 | $186.21 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $93.33 Typical High $138.04 | Professional | None | $16.60 | $93.33 | $138.04 |
Providence Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $3,801.89 | Facility | None | $100.00 | $181.97 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $218.78 | Professional | None | $117.49 | $151.36 | $218.78 |
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 $97.72 Median $134.90 Typical High $199.53 | Professional | None | $97.72 | $134.90 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $50.12 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $109.65 | Professional | 54 · Surgery only | $75.86 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $102.33 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 50 · Both sides | $190.55 | $204.17 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $58.88 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $58.88 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.44 Typical High $27.54 | Professional | 53 · Discontinued | $20.42 | $23.44 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $75.86 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $17.78 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.00 | $11.75 | $13.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $83.18 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $70.79 | $83.18 | $97.72 |
Where Texas sits
The same service costs 4.2 times more in Alaska than in Florida. 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
$123
AK $490FL $117
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.