How much rates vary
Facilitymedian $617 · 10th to 90th $162 to $3,162Professionalmedian $170 · 10th to 90th $30 to $1,479
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 $676.08 Median $2,570.40 Typical High $6,918.31 | Facility | None | $676.08 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $281.84 | Professional | None | $123.03 | $199.53 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
BCBS Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $1,380.38 | Facility | None | $158.49 | $229.09 | $1,380.38 |
BCBS Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $309.03 | Professional | None | $123.03 | $194.98 | $309.03 |
Christus Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,778.28 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $234.42 Typical High $2,290.87 | Facility | None | $165.96 | $234.42 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $302.00 | Professional | None | $131.83 | $208.93 | $302.00 |
Lucent Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,479.11 | $1,819.70 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $1,096.48 Typical High $4,786.30 | Facility | None | $141.25 | $1,096.48 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $281.84 | Professional | None | $123.03 | $199.53 | $281.84 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $144.54 Typical High $204.17 | Professional | None | $26.30 | $144.54 | $204.17 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $223.87 Typical High $2,290.87 | Facility | None | $162.18 | $223.87 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $302.00 | Professional | None | $131.83 | $204.17 | $302.00 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $109.65 Median $173.78 Typical High $281.84 | Professional | None | $109.65 | $173.78 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $61.66 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $24.55 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $131.83 Typical High $177.83 | Professional | 54 · Surgery only | $93.33 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $87.10 | $123.03 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $61.66 | $89.13 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $24.55 | $35.48 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $131.83 Typical High $177.83 | Professional | 54 · Surgery only | $93.33 | $131.83 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.30 Typical High $35.48 | Professional | 55 · Aftercare only | $18.62 | $26.30 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.30 | $17.78 | $23.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $123.03 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $87.10 | $123.03 | $165.96 |
Where Texas sits
The same service costs 3.9 times more in Oklahoma than in Kentucky. 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
$186
OK $646KY $166
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.