How much rates vary
Facilitymedian $186 · 10th to 90th $68 to $2,089Professionalmedian $135 · 10th to 90th $25 to $229
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $181.97 | Professional | None | $102.33 | $128.82 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $165.96 | Professional | None | $120.23 | $151.36 | $165.96 |
BCBS Setting Facility Modifier None Typical Low $60.26 Median $89.13 Typical High $602.56 | Facility | None | $60.26 | $89.13 | $602.56 |
BCBS Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $208.93 | Professional | None | $109.65 | $141.25 | $208.93 |
Baylor Scott & White Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $199.53 | Professional | None | $107.15 | $123.03 | $199.53 |
Christus Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $524.81 | Facility | None | $66.07 | $100.00 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | None | $128.82 | $165.96 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,380.38 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $794.33 Typical High $4,265.80 | Facility | None | $138.04 | $794.33 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $213.80 | Professional | None | $102.33 | $131.83 | $213.80 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $93.33 Typical High $173.78 | Professional | None | $16.60 | $93.33 | $173.78 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $426.58 | Facility | None | $66.07 | $104.71 | $426.58 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $223.87 | Professional | None | $128.82 | $165.96 | $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 $104.71 Median $144.54 Typical High $208.93 | Professional | None | $104.71 | $144.54 | $208.93 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
14 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 $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $30.90 | Professional | 53 · Discontinued | $20.42 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $97.72 Typical High $117.49 | Professional | 54 · Surgery only | $75.86 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $91.20 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $70.79 | $91.20 | $109.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 59 · Distinct service | $151.36 | $151.36 | $151.36 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | Q6 · Substitute physician, paid per time | $151.36 | $151.36 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $50.12 | $64.57 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $30.90 | Professional | 53 · Discontinued | $20.42 | $25.70 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $75.86 | $97.72 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.50 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $19.50 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $15.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $91.20 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $70.79 | $91.20 | $107.15 |
Where Texas sits
The same service costs 3.9 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· 50th of 51
$135
AK $501FL $129
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.