How much rates vary
Facilitymedian $1,622 · 10th to 90th $871 to $4,467Professionalmedian $676 · 10th to 90th $71 to $1,202
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 $870.96 Median $3,235.94 Typical High $8,511.38 | Facility | None | $870.96 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,258.93 | Professional | None | $616.60 | $870.96 | $1,258.93 |
Ambetter Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $954.99 | Professional | None | $676.08 | $676.08 | $954.99 |
BCBS Texas Setting Facility Modifier None Typical Low $912.01 Median $1,905.46 Typical High $4,570.88 | Facility | None | $912.01 | $1,905.46 | $4,570.88 |
BCBS Texas Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $1,513.56 | Professional | None | $676.08 | $954.99 | $1,513.56 |
Christus Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $2,691.53 | Facility | None | $691.83 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $776.25 | $1,000.00 | $1,348.96 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $8,511.38 | Professional | None | $7,244.36 | $7,244.36 | $8,511.38 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $2,041.74 Typical High $6,025.60 | Facility | None | $724.44 | $2,041.74 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $870.96 Typical High $1,318.26 | Professional | None | $616.60 | $870.96 | $1,318.26 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $151.36 Typical High $870.96 | Professional | None | $25.12 | $151.36 | $870.96 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $6,165.95 | Facility | None | $707.95 | $1,513.56 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $776.25 | $1,000.00 | $1,348.96 |
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 $676.08 Median $933.25 Typical High $1,348.96 | Professional | None | $676.08 | $933.25 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $309.03 Median $380.19 Typical High $478.63 | Professional | 52 · Reduced service | $309.03 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $190.55 | Professional | 53 · Discontinued | $123.03 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $724.44 | Professional | 54 · Surgery only | $467.74 | $575.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $144.54 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $380.19 Typical High $467.74 | Professional | 52 · Reduced service | $309.03 | $380.19 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $190.55 | Professional | 53 · Discontinued | $123.03 | $151.36 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $467.74 | $575.44 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $436.52 | $537.03 | $660.69 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 51st of 51
$741
AK $3,311TX $741
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.