How much rates vary
Facilitymedian $162 · 10th to 90th $79 to $2,291Professionalmedian $123 · 10th to 90th $21 to $182
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 $117.49 Median $134.90 Typical High $181.97 | Professional | None | $117.49 | $134.90 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Texas Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $776.25 | Facility | None | $79.43 | $117.49 | $776.25 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $181.97 | Professional | None | $107.15 | $134.90 | $181.97 |
Christus Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $109.65 Typical High $158.49 | Facility | None | $66.07 | $109.65 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $173.78 | Professional | None | $109.65 | $125.89 | $173.78 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $1,000.00 Typical High $4,677.35 | Facility | None | $117.49 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $181.97 | Professional | None | $117.49 | $134.90 | $181.97 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $91.20 Typical High $138.04 | Professional | None | $16.60 | $91.20 | $138.04 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $154.88 | Professional | None | $112.20 | $120.23 | $154.88 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $194.98 | Facility | None | $66.07 | $117.49 | $194.98 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $173.78 | Professional | None | $109.65 | $125.89 | $173.78 |
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 $91.20 Median $120.23 Typical High $173.78 | Professional | None | $91.20 | $120.23 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | None | $128.82 | $134.90 | $134.90 |
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 $58.88 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $58.88 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $33.11 | Professional | 53 · Discontinued | $23.44 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $125.89 | Professional | 54 · Surgery only | $87.10 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $95.50 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $81.28 | $95.50 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $58.88 | $67.61 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.92 Typical High $33.11 | Professional | 53 · Discontinued | $23.44 | $26.92 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $102.33 Typical High $125.89 | Professional | 54 · Surgery only | $87.10 | $102.33 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.42 Typical High $25.12 | Professional | 55 · Aftercare only | $17.38 | $20.42 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $11.75 | $13.49 | $16.60 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $95.50 Typical High $117.49 | Professional | 78 · Unplanned return to OR | $81.28 | $95.50 | $117.49 |
Where Texas sits
The same service costs 4.4 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
$123
AK $468FL $107
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.