How much rates vary
Facilitymedian $447 · 10th to 90th $126 to $2,512Professionalmedian $537 · 10th to 90th $65 to $871
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 $616.60 Median $3,715.35 Typical High $9,120.11 | Facility | None | $616.60 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $776.25 | Professional | None | $407.38 | $575.44 | $776.25 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $112.20 Median $239.88 Typical High $1,258.93 | Facility | None | $112.20 | $239.88 | $1,258.93 |
BCBS Texas Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,698.24 | Professional | None | $467.74 | $741.31 | $1,698.24 |
Christus Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $2,290.87 | Facility | None | $131.83 | $186.21 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,000.00 | Professional | None | $512.86 | $724.44 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $6,025.60 | Professional | None | $5,011.87 | $5,011.87 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $1,071.52 Typical High $6,918.31 | Facility | None | $489.78 | $1,071.52 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $812.83 | Professional | None | $407.38 | $575.44 | $812.83 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $416.87 Typical High $691.83 | Professional | None | $58.88 | $416.87 | $691.83 |
Providence Setting Facility Modifier None Typical Low $147.91 Median $239.88 Typical High $1,995.26 | Facility | None | $147.91 | $239.88 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,000.00 | Professional | None | $512.86 | $724.44 | $1,000.00 |
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 $446.68 Median $645.65 Typical High $977.24 | Professional | None | $446.68 | $645.65 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
13 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 $204.17 Median $288.40 Typical High $363.08 | Professional | 52 · Reduced service | $204.17 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $114.82 Typical High $144.54 | Professional | 53 · Discontinued | $81.28 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $426.58 Typical High $537.03 | Professional | 54 · Surgery only | $302.00 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $57.54 Typical High $72.44 | Professional | 56 · Pre-op care only | $40.74 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $398.11 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $281.84 | $398.11 | $501.19 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 79 · Unrelated procedure after surgery | $691.83 | $691.83 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $204.17 | $288.40 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $81.28 | $114.82 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $302.00 | $426.58 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $60.26 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $40.74 | $57.54 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $281.84 | $398.11 | $489.78 |
Where Texas sits
The same service costs 3.6 times more in Alaska than in Maryland. 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· 50th of 51
$537
AK $1,950MD $537
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.