How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,202 to $9,550Professionalmedian $363 · 10th to 90th $19 to $631
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $602.56 | Professional | None | $363.08 | $457.09 | $602.56 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,302.69 | Facility | None | $2,398.83 | $4,897.79 | $12,302.69 |
BCBS Texas Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $831.76 | Professional | None | $416.87 | $537.03 | $831.76 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $812.83 | Professional | None | $457.09 | $575.44 | $812.83 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $1,862.09 Typical High $6,606.93 | Facility | None | $478.63 | $1,862.09 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $676.08 | Professional | None | $363.08 | $457.09 | $676.08 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $97.72 Typical High $537.03 | Professional | None | $16.22 | $97.72 | $537.03 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $3,162.28 Typical High $4,786.30 | Facility | None | $549.54 | $3,162.28 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $794.33 | Professional | None | $446.68 | $575.44 | $794.33 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $776.25 | Professional | None | $389.05 | $524.81 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $181.97 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $181.97 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $72.44 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $436.52 | Professional | 54 · Surgery only | $269.15 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $87.10 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $323.59 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $251.19 | $323.59 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $229.09 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $91.20 Typical High $114.82 | Professional | 53 · Discontinued | $72.44 | $91.20 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $269.15 | $346.74 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $69.18 Typical High $85.11 | Professional | 55 · Aftercare only | $54.95 | $69.18 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $45.71 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $323.59 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $251.19 | $323.59 | $398.11 |
Where Texas sits
The same service costs 5.5 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
$380
AK $2,089TX $380
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.