How much rates vary
Facilitymedian $155 · 10th to 90th $95 to $2,188Professionalmedian $126 · 10th to 90th $22 to $240
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 $117.49 Median $151.36 Typical High $199.53 | Professional | None | $117.49 | $151.36 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $128.82 Typical High $138.04 | Professional | None | $64.57 | $128.82 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $93.33 Median $141.25 Typical High $891.25 | Facility | None | $93.33 | $141.25 | $891.25 |
BCBS Texas Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $177.83 | Professional | None | $95.50 | $134.90 | $177.83 |
Baylor Scott & White Setting Facility Modifier None Typical Low $114.82 Median $316.23 Typical High $549.54 | Facility | None | $114.82 | $316.23 | $549.54 |
Baylor Scott & White Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $245.47 | Professional | None | $138.04 | $165.96 | $245.47 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $169.82 | Facility | None | $66.07 | $117.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $199.53 | Professional | None | $109.65 | $134.90 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,202.26 | $1,230.27 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $1,000.00 Typical High $4,677.35 | Facility | None | $125.89 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $199.53 | Professional | None | $117.49 | $151.36 | $199.53 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $89.13 Typical High $138.04 | Professional | None | $16.60 | $89.13 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $177.83 Typical High $302.00 | Professional | None | $107.15 | $177.83 | $302.00 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $218.78 | Facility | None | $66.07 | $125.89 | $218.78 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $199.53 | Professional | None | $109.65 | $134.90 | $199.53 |
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 $95.50 Median $131.83 Typical High $194.98 | Professional | None | $95.50 | $131.83 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | None | $138.04 | $144.54 | $144.54 |
13 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 $58.88 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $89.13 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $104.71 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $83.18 | $104.71 | $128.82 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $208.93 Typical High $218.78 | Professional | 50 · Both sides | $194.98 | $208.93 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $58.88 | $75.86 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $23.44 | $30.20 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $89.13 | $112.20 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.75 | $15.14 | $18.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $104.71 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $83.18 | $104.71 | $128.82 |
Where Texas sits
The same service costs 4.1 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· 46th of 51
$132
AK $468FL $115
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.