How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,072 to $7,943Professionalmedian $178 · 10th to 90th $28 to $1,072
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 $758.58 Median $891.25 Typical High $3,548.13 | Professional | None | $758.58 | $891.25 | $3,548.13 |
BCBS Texas Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,737.80 | Professional | None | $912.01 | $1,122.02 | $1,737.80 |
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 $954.99 Median $1,122.02 Typical High $1,479.11 | Professional | None | $954.99 | $1,122.02 | $1,479.11 |
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 $7,244.36 Median $7,244.36 Typical High $7,943.28 | Professional | None | $7,244.36 | $7,244.36 | $7,943.28 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,511.89 Typical High $6,760.83 | Facility | None | $891.25 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,380.38 | Professional | None | $758.58 | $891.25 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $151.36 Typical High $831.76 | Professional | None | $25.12 | $151.36 | $831.76 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $2,511.89 Typical High $6,760.83 | Facility | None | $891.25 | $2,511.89 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,479.11 | Professional | None | $954.99 | $1,122.02 | $1,479.11 |
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 $776.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $776.25 | $1,047.13 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $380.19 Median $446.68 Typical High $512.86 | Professional | 52 · Reduced service | $380.19 | $446.68 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $151.36 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $102.33 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $446.68 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $446.68 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $151.36 | $177.83 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $676.08 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $707.95 |
Where Texas sits
The same service costs 8.3 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
$490
AK $4,074TX $490
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.