How much rates vary
Facilitymedian $269 · 10th to 90th $141 to $2,291Professionalmedian $316 · 10th to 90th $47 to $589
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 $251.19 Median $426.58 Typical High $602.56 | Professional | None | $251.19 | $426.58 | $602.56 |
BCBS Texas Setting Facility Modifier None Typical Low $138.04 Median $208.93 Typical High $1,202.26 | Facility | None | $138.04 | $208.93 | $1,202.26 |
BCBS Texas Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $537.03 | Professional | None | $229.09 | $380.19 | $537.03 |
Christus Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $213.80 Typical High $346.74 | Facility | None | $66.07 | $213.80 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $575.44 | Professional | None | $239.88 | $398.11 | $575.44 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $4,265.80 Typical High $4,265.80 | Professional | None | $3,715.35 | $4,265.80 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $1,023.29 Typical High $4,677.35 | Facility | None | $323.59 | $1,023.29 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $588.84 | Professional | None | $251.19 | $426.58 | $588.84 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $251.19 Typical High $426.58 | Professional | None | $33.11 | $251.19 | $426.58 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $229.09 Typical High $562.34 | Facility | None | $66.07 | $229.09 | $562.34 |
Providence Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $575.44 | Professional | None | $239.88 | $398.11 | $575.44 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $537.03 | Professional | None | $208.93 | $338.84 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | None | $416.87 | $436.52 | $436.52 |
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 $125.89 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $125.89 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $50.12 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $309.03 Typical High $416.87 | Professional | 54 · Surgery only | $190.55 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $61.66 Typical High $83.18 | Professional | 55 · Aftercare only | $38.02 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $25.12 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $288.40 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $177.83 | $288.40 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $199.53 Typical High $275.42 | Professional | 52 · Reduced service | $125.89 | $199.53 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $79.43 Typical High $109.65 | Professional | 53 · Discontinued | $50.12 | $79.43 | $109.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $295.12 Typical High $416.87 | Professional | 54 · Surgery only | $190.55 | $295.12 | $416.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $60.26 Typical High $83.18 | Professional | 55 · Aftercare only | $38.02 | $60.26 | $83.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $39.81 Typical High $54.95 | Professional | 56 · Pre-op care only | $25.12 | $39.81 | $54.95 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $275.42 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $177.83 | $275.42 | $389.05 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Maryland. 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· 48th of 51
$316
AK $1,023MD $302
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.