How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,514 to $12,882Professionalmedian $178 · 10th to 90th $29 to $1,000
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 $1,071.52 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,071.52 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,258.93 | Professional | None | $851.14 | $954.99 | $1,258.93 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $17,378.01 | Facility | None | $4,365.16 | $7,943.28 | $17,378.01 |
BCBS Texas Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,819.70 | Professional | None | $794.33 | $1,000.00 | $1,819.70 |
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 $954.99 Median $1,148.15 Typical High $1,621.81 | Professional | None | $954.99 | $1,148.15 | $1,621.81 |
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 $11,748.98 Median $11,748.98 Typical High $11,748.98 | Professional | None | $11,748.98 | $11,748.98 | $11,748.98 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $6,918.31 | Facility | None | $912.01 | $2,570.40 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,230.27 | Professional | None | $851.14 | $954.99 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $154.88 Typical High $831.76 | Professional | None | $27.54 | $154.88 | $831.76 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $3,715.35 Typical High $7,585.78 | Facility | None | $933.25 | $3,715.35 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,621.81 | Professional | None | $912.01 | $1,148.15 | $1,621.81 |
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 $812.83 Median $1,047.13 Typical High $1,584.89 | Professional | None | $812.83 | $1,047.13 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $426.58 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $426.58 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $169.82 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $467.74 Typical High $537.03 | Professional | 52 · Reduced service | $426.58 | $467.74 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $186.21 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $186.21 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $691.83 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $758.58 |
Where Texas sits
The same service costs 21.4 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
$191
AK $4,074TX $191
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.