How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,122 to $5,623Professionalmedian $331 · 10th to 90th $46 to $525
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $512.86 | Professional | None | $239.88 | $331.13 | $512.86 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $501.19 | Professional | None | $263.03 | $346.74 | $501.19 |
BCBS Texas Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $6,165.95 | Facility | None | $1,202.26 | $2,454.71 | $6,165.95 |
BCBS Texas Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $588.84 | Professional | None | $295.12 | $380.19 | $588.84 |
Christus Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,187.76 | Facility | None | $602.56 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $524.81 | Professional | None | $309.03 | $389.05 | $524.81 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,818.38 | $2,818.38 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $1,258.93 Typical High $4,786.30 | Facility | None | $331.13 | $1,258.93 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $512.86 | Professional | None | $239.88 | $331.13 | $512.86 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $257.04 Typical High $416.87 | Professional | None | $33.11 | $257.04 | $416.87 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $1,548.82 Typical High $4,466.84 | Facility | None | $407.38 | $1,548.82 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $524.81 | Professional | None | $309.03 | $389.05 | $524.81 |
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 $269.15 Median $371.54 Typical High $501.19 | Professional | None | $269.15 | $371.54 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $120.23 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $120.23 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $181.97 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $36.31 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $120.23 | $147.91 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $74.13 | Professional | 53 · Discontinued | $47.86 | $58.88 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $181.97 | $223.87 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $36.31 | $44.67 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $36.31 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $257.04 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 47th of 51
$355
AK $1,549NJ $347
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.