How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,096 to $7,244Professionalmedian $380 · 10th to 90th $24 to $724
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 $870.96 Median $4,073.80 Typical High $10,964.78 | Facility | None | $870.96 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $776.25 | Professional | None | $446.68 | $562.34 | $776.25 |
BCBS Texas Setting Facility Modifier None Typical Low $1,230.27 Median $2,951.21 Typical High $7,244.36 | Facility | None | $1,230.27 | $2,951.21 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,698.24 | Professional | None | $512.86 | $724.44 | $1,698.24 |
Christus Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $5,248.07 | Facility | None | $1,288.25 | $2,754.23 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,000.00 | Professional | None | $537.03 | $676.08 | $1,000.00 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,511.38 | Facility | None | $588.84 | $1,862.09 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $794.33 | Professional | None | $446.68 | $562.34 | $794.33 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $602.56 | Professional | None | $21.88 | $117.49 | $602.56 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $9,772.37 | Facility | None | $758.58 | $2,884.03 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $977.24 | Professional | None | $537.03 | $676.08 | $977.24 |
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 $489.78 Median $676.08 Typical High $977.24 | Professional | None | $489.78 | $676.08 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $223.87 Median $275.42 Typical High $346.74 | Professional | 52 · Reduced service | $223.87 | $275.42 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $91.20 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $407.38 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $69.18 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $275.42 Typical High $346.74 | Professional | 52 · Reduced service | $223.87 | $275.42 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $138.04 | Professional | 53 · Discontinued | $91.20 | $109.65 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $407.38 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $69.18 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $478.63 |
Where Texas sits
The same service costs 6.2 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
$417
AK $2,570TX $417
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.