How much rates vary
Facilitymedian $1,585 · 10th to 90th $646 to $6,026Professionalmedian $437 · 10th to 90th $30 to $851
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 $954.99 Median $4,073.80 Typical High $10,964.78 | Facility | None | $954.99 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $870.96 | Professional | None | $537.03 | $676.08 | $870.96 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,288.25 | Professional | None | $524.81 | $758.58 | $1,288.25 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $912.01 Typical High $4,265.80 | Facility | None | $645.65 | $912.01 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,096.48 | Professional | None | $660.69 | $851.14 | $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 $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $1,698.24 Typical High $7,585.78 | Facility | None | $660.69 | $1,698.24 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $870.96 | Professional | None | $537.03 | $676.08 | $870.96 |
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 $707.95 Median $1,096.48 Typical High $9,772.37 | Facility | None | $707.95 | $1,096.48 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,096.48 | Professional | None | $645.65 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $1,071.52 | Professional | None | $512.86 | $707.95 | $1,071.52 |
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 $269.15 Median $338.84 Typical High $426.58 | Professional | 52 · Reduced service | $269.15 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $138.04 Typical High $169.82 | Professional | 53 · Discontinued | $107.15 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $645.65 | Professional | 54 · Surgery only | $407.38 | $512.86 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $128.82 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $85.11 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $269.15 | $338.84 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $107.15 | $138.04 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $512.86 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $83.18 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $575.44 |
Where Texas sits
The same service costs 5.6 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
$468
AK $2,630TX $468
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.