How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,000 to $7,943Professionalmedian $141 · 10th to 90th $22 to $851
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 $1,000.00 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $3,019.95 | Professional | None | $602.56 | $707.95 | $3,019.95 |
BCBS Texas Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,258.93 | Professional | None | $630.96 | $794.33 | $1,258.93 |
Christus Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,398.83 Typical High $3,311.31 | Facility | None | $870.96 | $2,398.83 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,122.02 | Professional | None | $741.31 | $870.96 | $1,122.02 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,309.57 | Professional | None | $5,754.40 | $5,754.40 | $6,309.57 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $2,511.89 Typical High $6,760.83 | Facility | None | $707.95 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,096.48 | Professional | None | $602.56 | $707.95 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $120.23 Typical High $660.69 | Professional | None | $19.95 | $120.23 | $660.69 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,511.89 Typical High $6,760.83 | Facility | None | $812.83 | $2,511.89 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,174.90 | Professional | None | $741.31 | $870.96 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,096.48 | Professional | None | $616.60 | $831.76 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $302.00 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $158.49 | Professional | 53 · Discontinued | $120.23 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $537.03 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $354.81 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $354.81 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $141.25 Typical High $162.18 | Professional | 53 · Discontinued | $120.23 | $141.25 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $537.03 | $602.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $120.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $70.79 Typical High $79.43 | Professional | 56 · Pre-op care only | $60.26 | $70.79 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $562.34 |
Where Texas sits
The same service costs 8.1 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
$398
AK $3,236TX $398
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.