How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,585 to $13,183Professionalmedian $209 · 10th to 90th $35 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 $1,122.02 Median $4,073.80 Typical High $10,964.78 | Facility | None | $1,122.02 | $4,073.80 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,202.26 | Professional | None | $851.14 | $933.25 | $1,202.26 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $8,317.64 Typical High $17,378.01 | Facility | None | $4,365.16 | $8,317.64 | $17,378.01 |
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 $851.14 Median $3,467.37 Typical High $4,897.79 | Facility | None | $851.14 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,548.82 | Professional | None | $912.01 | $1,122.02 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,041.74 Typical High $8,128.31 | Facility | None | $891.25 | $2,041.74 | $8,128.31 |
Moda Health Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,202.26 | Professional | None | $851.14 | $954.99 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $165.96 Typical High $812.83 | Professional | None | $32.36 | $165.96 | $812.83 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $3,388.44 Typical High $4,897.79 | Facility | None | $870.96 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,548.82 | Professional | None | $912.01 | $1,122.02 | $1,548.82 |
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 $794.33 Median $1,000.00 Typical High $1,584.89 | Professional | None | $794.33 | $1,000.00 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $416.87 Median $467.74 Typical High $537.03 | Professional | 52 · Reduced service | $416.87 | $467.74 | $537.03 |
Aetna 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 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $630.96 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $162.18 |
Aetna 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 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $467.74 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $467.74 | $524.81 |
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 $630.96 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $691.83 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $93.33 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $741.31 |
Where Texas sits
The same service costs 18.2 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
$224
AK $4,074TX $224
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.