How much rates vary
Facilitymedian $3,467 · 10th to 90th $631 to $8,511Professionalmedian $372 · 10th to 90th $30 to $741
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 $302.00 Median $537.03 Typical High $691.83 | Professional | None | $302.00 | $537.03 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $954.99 | Professional | None | $346.74 | $575.44 | $954.99 |
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 $380.19 Median $588.84 Typical High $891.25 | Professional | None | $380.19 | $588.84 | $891.25 |
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 $4,466.84 Median $4,466.84 Typical High $5,495.41 | Professional | None | $4,466.84 | $4,466.84 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,786.30 | Facility | None | $338.84 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $537.03 Typical High $691.83 | Professional | None | $302.00 | $537.03 | $691.83 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $125.89 Typical High $588.84 | Professional | None | $26.30 | $125.89 | $588.84 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $3,162.28 Typical High $4,786.30 | Facility | None | $524.81 | $3,162.28 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $891.25 | Professional | None | $380.19 | $575.44 | $891.25 |
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 $316.23 Median $549.54 Typical High $1,000.00 | Professional | None | $316.23 | $549.54 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $151.36 Median $269.15 Typical High $338.84 | Professional | 52 · Reduced service | $151.36 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $60.26 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $223.87 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $44.67 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $53.70 Typical High $67.61 | Professional | 56 · Pre-op care only | $30.20 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $208.93 | $380.19 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $151.36 | $269.15 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $107.15 Typical High $128.82 | Professional | 53 · Discontinued | $60.26 | $107.15 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $407.38 Typical High $489.78 | Professional | 54 · Surgery only | $223.87 | $407.38 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $81.28 Typical High $97.72 | Professional | 55 · Aftercare only | $44.67 | $81.28 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $30.20 | $53.70 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $380.19 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $208.93 | $380.19 | $457.09 |
Where Texas sits
The same service costs 4.9 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
$380
AK $1,862TX $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.