How much rates vary
Facilitymedian $1,549 · 10th to 90th $776 to $8,128Professionalmedian $1,000 · 10th to 90th $66 to $1,905
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 $1,230.27 Median $1,412.54 Typical High $1,621.81 | Facility | None | $1,230.27 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,412.54 | $1,778.28 |
BCBS Texas Setting Facility Modifier None Typical Low $724.44 Median $1,230.27 Typical High $4,168.69 | Facility | None | $724.44 | $1,230.27 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $4,073.80 | Professional | None | $1,258.93 | $1,862.09 | $4,073.80 |
Christus Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $2,290.87 | Facility | None | $758.58 | $1,071.52 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,778.28 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $14,791.08 | Professional | None | $12,302.69 | $12,302.69 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,570.40 | Facility | None | $1,148.15 | $1,737.80 | $2,570.40 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,412.54 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $309.03 Typical High $1,548.82 | Professional | None | $58.88 | $309.03 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $2,570.40 | Facility | None | $776.25 | $1,174.90 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,778.28 | $2,511.89 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,659.59 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
10 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 $562.34 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $562.34 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $223.87 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $169.82 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $141.25 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $776.25 | $1,000.00 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $707.95 Typical High $870.96 | Professional | 52 · Reduced service | $562.34 | $707.95 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $281.84 Typical High $354.81 | Professional | 53 · Discontinued | $223.87 | $281.84 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $263.03 | Professional | 55 · Aftercare only | $169.82 | $213.80 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $141.25 Typical High $177.83 | Professional | 56 · Pre-op care only | $112.20 | $141.25 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $1,000.00 | $1,230.27 |
Where Texas sits
The same service costs 5.1 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
$1,023
AK $5,248TX $1,023
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.