How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,148 to $6,310Professionalmedian $148 · 10th to 90th $22 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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $3,311.31 | Professional | None | $707.95 | $831.76 | $3,311.31 |
BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,202.26 | $2,570.40 | $6,309.57 |
BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None | $831.76 | $1,071.52 | $1,621.81 |
Christus Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,691.53 | Facility | None | $691.83 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,348.96 | Professional | None | $870.96 | $1,023.29 | $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 $6,760.83 Median $6,760.83 Typical High $7,244.36 | Professional | None | $6,760.83 | $6,760.83 | $7,244.36 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $2,398.83 Typical High $6,025.60 | Facility | None | $812.83 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,288.25 | Professional | None | $707.95 | $831.76 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $125.89 Typical High $758.58 | Professional | None | $20.42 | $125.89 | $758.58 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $6,165.95 | Facility | None | $758.58 | $1,737.80 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,348.96 | Professional | None | $870.96 | $1,023.29 | $1,348.96 |
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 $724.44 Median $977.24 Typical High $1,318.26 | Professional | None | $724.44 | $977.24 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $346.74 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $141.25 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $524.81 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $346.74 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $165.96 Typical High $186.21 | Professional | 53 · Discontinued | $141.25 | $165.96 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $524.81 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $660.69 |
Where Texas sits
The same service costs 7.1 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
$537
AK $3,802TX $537
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.