How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $6,026Professionalmedian $141 · 10th to 90th $22 to $676
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $2,570.40 | Professional | None | $489.78 | $575.44 | $2,570.40 |
BCBS Texas Setting Facility Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $8,317.64 | Facility | None | $2,089.30 | $3,981.07 | $8,317.64 |
BCBS Texas Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $891.25 | Professional | None | $512.86 | $645.65 | $891.25 |
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 $758.58 Median $1,584.89 Typical High $2,691.53 | Facility | None | $758.58 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $891.25 | Professional | None | $602.56 | $707.95 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,128.61 | Professional | None | $4,677.35 | $4,677.35 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $5,623.41 | Facility | None | $575.44 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | None | $489.78 | $575.44 | $912.01 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $104.71 Typical High $537.03 | Professional | None | $19.95 | $104.71 | $537.03 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,548.82 Typical High $2,691.53 | Facility | None | $616.60 | $1,548.82 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $912.01 | Professional | None | $602.56 | $707.95 | $912.01 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,890.45 | Facility | None | $616.60 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $891.25 | Professional | None | $501.19 | $676.08 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $288.40 Typical High $323.59 | Professional | 52 · Reduced service | $245.47 | $288.40 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $128.82 | Professional | 53 · Discontinued | $97.72 | $114.82 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $426.58 Typical High $478.63 | Professional | 54 · Surgery only | $371.54 | $426.58 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $64.57 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $398.11 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $346.74 | $398.11 | $446.68 |
Where Texas sits
The same service costs 7.2 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
$363
AK $2,630TX $363
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.