How much rates vary
Facilitymedian $1,445 · 10th to 90th $617 to $4,169Professionalmedian $302 · 10th to 90th $42 to $513
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $549.54 | Professional | None | $213.80 | $302.00 | $549.54 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $3,801.89 | Facility | None | $691.83 | $1,445.44 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $575.44 | Professional | None | $257.04 | $371.54 | $575.44 |
Christus Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $524.81 | Professional | None | $269.15 | $380.19 | $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 $3,388.44 | Professional | None | $2,818.38 | $2,818.38 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $295.12 Median $1,148.15 Typical High $4,786.30 | Facility | None | $295.12 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $549.54 | Professional | None | $213.80 | $302.00 | $549.54 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $223.87 Typical High $398.11 | Professional | None | $33.11 | $223.87 | $398.11 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $1,000.00 Typical High $4,466.84 | Facility | None | $398.11 | $1,000.00 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $524.81 | Professional | None | $269.15 | $380.19 | $524.81 |
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 $234.42 Median $338.84 Typical High $501.19 | Professional | None | $234.42 | $338.84 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $107.15 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $107.15 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $42.66 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $147.91 | $208.93 | $257.04 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 51 · Multiple procedures | $117.49 | $117.49 | $117.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $107.15 | $147.91 | $186.21 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $42.66 | $60.26 | $74.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $158.49 | $223.87 | $275.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $31.62 | $44.67 | $54.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $21.38 | $30.20 | $37.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $147.91 | $208.93 | $257.04 |
Where Texas sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 50th of 51
$331
AK $1,259UT $324
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.