How much rates vary
Facilitymedian $363 · 10th to 90th $186 to $2,818Professionalmedian $251 · 10th to 90th $36 to $380
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 $234.42 Median $302.00 Typical High $407.38 | Professional | None | $234.42 | $302.00 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $309.03 | Professional | None | $194.98 | $288.40 | $309.03 |
BCBS Texas Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $1,584.89 | Facility | None | $186.21 | $275.42 | $1,584.89 |
BCBS Texas Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $380.19 | Professional | None | $213.80 | $281.84 | $380.19 |
Baylor Scott & White Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $512.86 | Professional | None | $288.40 | $331.13 | $512.86 |
Christus Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $281.84 Typical High $1,412.54 | Facility | None | $199.53 | $281.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $407.38 | Professional | None | $218.78 | $275.42 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $1,000.00 Typical High $4,570.88 | Facility | None | $288.40 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $407.38 | Professional | None | $234.42 | $302.00 | $407.38 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $177.83 Typical High $302.00 | Professional | None | $31.62 | $177.83 | $302.00 |
Oscar Health Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $1,000.00 | Facility | None | $181.97 | $208.93 | $1,000.00 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $616.60 | Professional | None | $213.80 | $398.11 | $616.60 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $3,801.89 | Facility | None | $218.78 | $398.11 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $398.11 | Professional | None | $218.78 | $281.84 | $398.11 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,090.30 | Facility | None | $389.05 | $1,230.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $478.63 | Professional | None | $204.17 | $288.40 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | None | $288.40 | $302.00 | $302.00 |
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 $117.49 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $117.49 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $213.80 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $117.49 | $151.36 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $60.26 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $229.09 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $45.71 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.44 | $30.20 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $213.80 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $213.80 | $263.03 |
Where Texas sits
The same service costs 4.2 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
$257
AK $955UT $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.