How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,380 to $12,589Professionalmedian $148 · 10th to 90th $23 to $891
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,071.52 | Professional | None | $741.31 | $812.83 | $1,071.52 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $17,378.01 | Facility | None | $4,365.16 | $7,943.28 | $17,378.01 |
BCBS Texas Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,995.26 | Professional | None | $794.33 | $1,000.00 | $1,995.26 |
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 $691.83 Median $3,467.37 Typical High $4,897.79 | Facility | None | $691.83 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,412.54 | Professional | None | $812.83 | $977.24 | $1,412.54 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $6,025.60 | Facility | None | $776.25 | $2,511.89 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $933.25 | Professional | None | $741.31 | $794.33 | $933.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $128.82 Typical High $707.95 | Professional | None | $21.88 | $128.82 | $707.95 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $3,548.13 Typical High $6,606.93 | Facility | None | $758.58 | $3,548.13 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,380.38 | Professional | None | $776.25 | $977.24 | $1,380.38 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,348.96 | Professional | None | $676.08 | $870.96 | $1,348.96 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $371.54 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $398.11 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $158.49 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $602.56 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $645.65 |
Where Texas sits
The same service costs 20.9 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
$166
AK $3,467TX $166
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.