How much rates vary
Facilitymedian $389 · 10th to 90th $151 to $3,311Professionalmedian $269 · 10th to 90th $37 to $468
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 $676.08 Median $2,570.40 Typical High $6,918.31 | Facility | None | $676.08 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $501.19 | Professional | None | $204.17 | $309.03 | $501.19 |
BCBS Texas Setting Facility Modifier None Typical Low $162.18 Median $295.12 Typical High $1,659.59 | Facility | None | $162.18 | $295.12 | $1,659.59 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $537.03 | Professional | None | $251.19 | $346.74 | $537.03 |
Christus Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $234.42 Typical High $338.84 | Facility | None | $66.07 | $234.42 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $478.63 | Professional | None | $263.03 | $363.08 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,019.95 | Professional | None | $2,570.40 | $2,570.40 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $1,148.15 Typical High $4,786.30 | Facility | None | $251.19 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $501.19 | Professional | None | $204.17 | $316.23 | $501.19 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $204.17 Typical High $331.13 | Professional | None | $32.36 | $204.17 | $331.13 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $251.19 Typical High $426.58 | Facility | None | $66.07 | $251.19 | $426.58 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $478.63 | Professional | None | $263.03 | $363.08 | $478.63 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $457.09 | Professional | None | $229.09 | $316.23 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $100.00 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $100.00 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $40.74 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $151.36 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $234.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $100.00 | $134.90 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $40.74 | $54.95 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $151.36 | $204.17 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $30.20 | $40.74 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $141.25 | $190.55 | $234.42 |
Where Texas sits
The same service costs 4.0 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
$275
AK $1,096TX $275
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.