How much rates vary
Facilitymedian $1,047 · 10th to 90th $288 to $5,012Professionalmedian $200 · 10th to 90th $22 to $427
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 $549.54 Median $2,238.72 Typical High $6,918.31 | Facility | None | $549.54 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $416.87 | Professional | None | $218.78 | $323.59 | $416.87 |
BCBS Texas Setting Facility Modifier None Typical Low $269.15 Median $457.09 Typical High $2,511.89 | Facility | None | $269.15 | $457.09 | $2,511.89 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $724.44 | Professional | None | $251.19 | $398.11 | $724.44 |
Christus Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $2,290.87 | Facility | None | $257.04 | $371.54 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $537.03 | Professional | None | $275.42 | $389.05 | $537.03 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,311.31 | Professional | None | $2,691.53 | $2,691.53 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $1,000.00 Typical High $4,677.35 | Facility | None | $288.40 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $416.87 | Professional | None | $218.78 | $323.59 | $416.87 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $81.28 Typical High $331.13 | Professional | None | $16.60 | $81.28 | $331.13 |
Providence Setting Facility Modifier None Typical Low $269.15 Median $371.54 Typical High $1,995.26 | Facility | None | $269.15 | $371.54 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $524.81 | Professional | None | $275.42 | $389.05 | $524.81 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $501.19 | Professional | None | $229.09 | $338.84 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $109.65 Median $162.18 Typical High $199.53 | Professional | 52 · Reduced service | $109.65 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $302.00 | Professional | 54 · Surgery only | $165.96 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $47.86 Typical High $60.26 | Professional | 55 · Aftercare only | $33.11 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $109.65 | $162.18 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $44.67 | $64.57 | $77.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $165.96 | $239.88 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $47.86 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $32.36 | $38.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $269.15 |
Where Texas sits
The same service costs 5.2 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
$219
AK $1,148TX $219
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.