How much rates vary
Facilitymedian $490 · 10th to 90th $186 to $3,467Professionalmedian $151 · 10th to 90th $28 to $347
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $234.42 Typical High $331.13 | Professional | None | $97.72 | $234.42 | $331.13 |
BCBS Texas Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $1,584.89 | Facility | None | $186.21 | $281.84 | $1,584.89 |
BCBS Texas Setting Professional Modifier None Typical Low $89.13 Median $204.17 Typical High $295.12 | Professional | None | $89.13 | $204.17 | $295.12 |
Christus Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $288.40 Typical High $1,412.54 | Facility | None | $204.17 | $288.40 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $309.03 | Professional | None | $91.20 | $204.17 | $309.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,995.26 | $1,995.26 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $1,000.00 Typical High $4,570.88 | Facility | None | $100.00 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $229.09 Typical High $323.59 | Professional | None | $97.72 | $229.09 | $323.59 |
Molina Setting Professional Modifier None Typical Low $5.89 Median $38.90 Typical High $234.42 | Professional | None | $5.89 | $38.90 | $234.42 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $338.84 Typical High $3,801.89 | Facility | None | $199.53 | $338.84 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $309.03 | Professional | None | $91.20 | $204.17 | $309.03 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $275.42 | Professional | None | $79.43 | $173.78 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | None | $229.09 | $239.88 | $239.88 |
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 $48.98 Median $97.72 Typical High $158.49 | Professional | 52 · Reduced service | $48.98 | $97.72 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $38.90 Typical High $63.10 | Professional | 53 · Discontinued | $19.50 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $147.91 Typical High $239.88 | Professional | 54 · Surgery only | $74.13 | $147.91 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $29.51 Typical High $47.86 | Professional | 55 · Aftercare only | $14.79 | $29.51 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $19.50 Typical High $31.62 | Professional | 56 · Pre-op care only | $9.77 | $19.50 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $138.04 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $69.18 | $138.04 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $102.33 Typical High $158.49 | Professional | 52 · Reduced service | $48.98 | $102.33 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $40.74 Typical High $63.10 | Professional | 53 · Discontinued | $19.50 | $40.74 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $74.13 | $151.36 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $14.79 | $30.20 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $20.42 Typical High $31.62 | Professional | 56 · Pre-op care only | $9.77 | $20.42 | $31.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $141.25 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $69.18 | $141.25 | $223.87 |
Where Texas sits
The same service costs 5.6 times more in Alaska than in Kentucky. 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· 43rd of 51
$186
AK $562KY $100
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.