How much rates vary
Facilitymedian $282 · 10th to 90th $87 to $4,266Professionalmedian $148 · 10th to 90th $25 to $324
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $218.78 | Professional | None | $147.91 | $162.18 | $218.78 |
BCBS Texas Setting Facility Modifier None Typical Low $87.10 Median $128.82 Typical High $812.83 | Facility | None | $87.10 | $128.82 | $812.83 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $234.42 | Professional | None | $138.04 | $173.78 | $234.42 |
Christus Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $134.90 Typical High $1,412.54 | Facility | None | $95.50 | $134.90 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $158.49 Typical High $208.93 | Professional | None | $141.25 | $158.49 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,348.96 | $2,290.87 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $1,000.00 Typical High $4,677.35 | Facility | None | $151.36 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $218.78 | Professional | None | $147.91 | $162.18 | $218.78 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $91.20 Typical High $173.78 | Professional | None | $16.60 | $91.20 | $173.78 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $229.09 Typical High $3,801.89 | Facility | None | $109.65 | $229.09 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $208.93 | Professional | None | $141.25 | $162.18 | $208.93 |
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 $120.23 Median $154.88 Typical High $218.78 | Professional | None | $120.23 | $154.88 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | None | $154.88 | $158.49 | $158.49 |
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 $74.13 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $112.20 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $104.71 | $112.20 | $144.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $79.43 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $79.43 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $29.51 | $32.36 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $112.20 | $120.23 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $23.99 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $16.22 | $20.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $112.20 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $104.71 | $112.20 | $144.54 |
Where Texas sits
The same service costs 4.6 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· 45th of 51
$151
AK $603FL $132
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.