How much rates vary
Facilitymedian $1,738 · 10th to 90th $302 to $5,623Professionalmedian $229 · 10th to 90th $34 to $417
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 $724.44 Median $3,311.31 Typical High $8,709.64 | Facility | None | $724.44 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $436.52 | Professional | None | $199.53 | $323.59 | $436.52 |
BCBS Texas Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $389.05 | Professional | None | $181.97 | $275.42 | $389.05 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $346.74 Typical High $1,412.54 | Facility | None | $251.19 | $346.74 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $407.38 | Professional | None | $186.21 | $281.84 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,691.53 | $3,388.44 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $1,230.27 Typical High $5,495.41 | Facility | None | $213.80 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $426.58 | Professional | None | $199.53 | $316.23 | $426.58 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $151.36 Typical High $295.12 | Professional | None | $29.51 | $151.36 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $363.08 | Professional | None | $194.98 | $208.93 | $363.08 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $3,801.89 | Facility | None | $269.15 | $407.38 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $281.84 Typical High $407.38 | Professional | None | $186.21 | $281.84 | $407.38 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $407.38 | Professional | None | $169.82 | $263.03 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | None | $302.00 | $316.23 | $316.23 |
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 $100.00 Median $154.88 Typical High $204.17 | Professional | 52 · Reduced service | $100.00 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $61.66 Typical High $81.28 | Professional | 53 · Discontinued | $39.81 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $229.09 Typical High $302.00 | Professional | 54 · Surgery only | $147.91 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $19.95 | $30.90 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $213.80 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $138.04 | $213.80 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $151.36 Typical High $204.17 | Professional | 52 · Reduced service | $100.00 | $151.36 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $60.26 Typical High $81.28 | Professional | 53 · Discontinued | $39.81 | $60.26 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $229.09 Typical High $302.00 | Professional | 54 · Surgery only | $147.91 | $229.09 | $302.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $61.66 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $30.20 Typical High $40.74 | Professional | 56 · Pre-op care only | $19.95 | $30.20 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $213.80 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $138.04 | $213.80 | $281.84 |
Where Texas sits
The same service costs 4.3 times more in Wyoming 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
$240
WY $933UT $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.