How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,778 to $11,220Professionalmedian $457 · 10th to 90th $30 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 $933.25 Median $3,801.89 Typical High $9,120.11 | Facility | None | $933.25 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $891.25 | Professional | None | $524.81 | $707.95 | $891.25 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,589.25 | Facility | None | $2,398.83 | $4,897.79 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,737.80 | Professional | None | $575.44 | $851.14 | $1,737.80 |
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 $954.99 Median $3,715.35 Typical High $4,897.79 | Facility | None | $954.99 | $3,715.35 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
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 $10,000.00 Median $10,000.00 Typical High $10,000.00 | Professional | None | $10,000.00 | $10,000.00 | $10,000.00 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $1,513.56 Typical High $6,606.93 | Facility | None | $645.65 | $1,513.56 | $6,606.93 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $912.01 | Professional | None | $549.54 | $707.95 | $912.01 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $144.54 Typical High $724.44 | Professional | None | $26.92 | $144.54 | $724.44 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $3,630.78 Typical High $7,585.78 | Facility | None | $776.25 | $3,630.78 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,096.48 | Professional | None | $630.96 | $812.83 | $1,096.48 |
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 $524.81 Median $707.95 Typical High $1,096.48 | Professional | None | $524.81 | $707.95 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $263.03 Median $354.81 Typical High $436.52 | Professional | 52 · Reduced service | $263.03 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $141.25 Typical High $177.83 | Professional | 53 · Discontinued | $104.71 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $524.81 Typical High $660.69 | Professional | 54 · Surgery only | $398.11 | $524.81 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $104.71 Typical High $131.83 | Professional | 55 · Aftercare only | $79.43 | $104.71 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $70.79 Typical High $89.13 | Professional | 56 · Pre-op care only | $52.48 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $489.78 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $371.54 | $489.78 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $354.81 Typical High $426.58 | Professional | 52 · Reduced service | $263.03 | $354.81 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $141.25 Typical High $169.82 | Professional | 53 · Discontinued | $104.71 | $141.25 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $398.11 | $524.81 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $79.43 | $104.71 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $70.79 Typical High $85.11 | Professional | 56 · Pre-op care only | $52.48 | $70.79 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $371.54 | $489.78 | $588.84 |
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
$490
AK $3,020TX $490
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.