How much rates vary
Facilitymedian $1,820 · 10th to 90th $832 to $4,677Professionalmedian $525 · 10th to 90th $33 to $977
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 $776.25 Median $3,235.94 Typical High $8,511.38 | Facility | None | $776.25 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,096.48 | Professional | None | $489.78 | $691.83 | $1,096.48 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
BCBS Texas Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $4,570.88 | Facility | None | $954.99 | $1,905.46 | $4,570.88 |
BCBS Texas Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,202.26 | Professional | None | $602.56 | $776.25 | $1,202.26 |
Christus Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
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 $5,754.40 Median $5,754.40 Typical High $6,760.83 | Professional | None | $5,754.40 | $5,754.40 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $1,778.28 Typical High $5,495.41 | Facility | None | $630.96 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,071.52 | Professional | None | $489.78 | $691.83 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $138.04 Typical High $707.95 | Professional | None | $25.12 | $138.04 | $707.95 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $6,165.95 | Facility | None | $660.69 | $1,513.56 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
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 $549.54 Median $758.58 Typical High $1,047.13 | Professional | None | $549.54 | $758.58 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $245.47 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $245.47 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $151.36 | Professional | 53 · Discontinued | $97.72 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $457.09 Typical High $575.44 | Professional | 54 · Surgery only | $371.54 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $74.13 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $75.86 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $426.58 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $346.74 | $426.58 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $245.47 | $302.00 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $97.72 | $120.23 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $371.54 | $457.09 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $74.13 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $346.74 | $426.58 | $524.81 |
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
$589
AK $2,630TX $589
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.