How much rates vary
Facilitymedian $437 · 10th to 90th $170 to $3,715Professionalmedian $257 · 10th to 90th $29 to $617
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 $912.01 Median $3,715.35 Typical High $9,120.11 | Facility | None | $912.01 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $676.08 | Professional | None | $275.42 | $323.59 | $676.08 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $691.83 | Professional | None | $223.87 | $302.00 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $1,513.56 | Facility | None | $169.82 | $257.04 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $426.58 | Professional | None | $251.19 | $316.23 | $426.58 |
Christus Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $257.04 Typical High $1,412.54 | Facility | None | $181.97 | $257.04 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $707.95 | Professional | None | $257.04 | $302.00 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $1,659.59 Typical High $6,760.83 | Facility | None | $288.40 | $1,659.59 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $676.08 | Professional | None | $275.42 | $323.59 | $676.08 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $43.65 Typical High $269.15 | Professional | None | $5.89 | $43.65 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $630.96 | Professional | None | $251.19 | $467.74 | $630.96 |
Providence Setting Facility Modifier None Typical Low $213.80 Median $416.87 Typical High $3,801.89 | Facility | None | $213.80 | $416.87 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $691.83 | Professional | None | $257.04 | $323.59 | $691.83 |
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 $229.09 Median $478.63 Typical High $812.83 | Professional | None | $229.09 | $478.63 | $812.83 |
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 $138.04 Median $147.91 Typical High $194.98 | Professional | 52 · Reduced service | $138.04 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $77.62 | Professional | 53 · Discontinued | $54.95 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $147.91 Typical High $194.98 | Professional | 52 · Reduced service | $138.04 | $147.91 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $60.26 Typical High $77.62 | Professional | 53 · Discontinued | $54.95 | $60.26 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $295.12 | Professional | 54 · Surgery only | $204.17 | $223.87 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $58.88 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $29.51 Typical High $38.90 | Professional | 56 · Pre-op care only | $27.54 | $29.51 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $275.42 |
Where Texas sits
The same service costs 5.0 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· 49th of 51
$269
AK $1,096UT $219
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.