How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,230 to $9,120Professionalmedian $282 · 10th to 90th $46 to $1,445
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 $1,202.26 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,202.26 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,348.96 | $1,659.59 |
BCBS Texas Setting Facility Modifier None Typical Low $1,148.15 Median $2,884.03 Typical High $7,762.47 | Facility | None | $1,148.15 | $2,884.03 | $7,762.47 |
BCBS Texas Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,659.59 | $3,090.30 |
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 $794.33 Median $3,467.37 Typical High $4,897.79 | Facility | None | $794.33 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,584.89 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,125.38 | Professional | None | $14,125.38 | $14,125.38 | $14,125.38 |
Moda Health Setting Facility Modifier None Typical Low $1,071.52 Median $3,467.37 Typical High $9,549.93 | Facility | None | $1,071.52 | $3,467.37 | $9,549.93 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,202.26 | $1,348.96 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $229.09 Typical High $1,174.90 | Professional | None | $42.66 | $229.09 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $3,467.37 Typical High $4,897.79 | Facility | None | $933.25 | $3,467.37 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,584.89 | $2,238.72 |
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 $1,122.02 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,445.44 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $602.56 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,071.52 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | GC · Resident with teaching physician | $741.31 | $741.31 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $645.65 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $257.04 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,047.13 |
Where Texas sits
The same service costs 17.8 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
$316
AK $5,623TX $316
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.