How much rates vary
Facilitymedian $1,259 · 10th to 90th $631 to $3,890Professionalmedian $288 · 10th to 90th $30 to $617
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 $776.25 Median $3,235.94 Typical High $8,511.38 | Facility | None | $776.25 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $562.34 | Professional | None | $275.42 | $436.52 | $562.34 |
BCBS Texas Setting Facility Modifier None Typical Low $660.69 Median $1,230.27 Typical High $2,511.89 | Facility | None | $660.69 | $1,230.27 | $2,511.89 |
BCBS Texas Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $1,023.29 | Professional | None | $323.59 | $512.86 | $1,023.29 |
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 $616.60 Median $851.14 Typical High $2,691.53 | Facility | None | $616.60 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $691.83 | Professional | None | $338.84 | $478.63 | $691.83 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,786.30 | Professional | None | $3,630.78 | $3,630.78 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $1,318.26 Typical High $5,248.07 | Facility | None | $331.13 | $1,318.26 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $562.34 | Professional | None | $275.42 | $436.52 | $562.34 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $120.23 Typical High $524.81 | Professional | None | $26.30 | $120.23 | $524.81 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $6,165.95 | Facility | None | $512.86 | $912.01 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $691.83 | Professional | None | $338.84 | $478.63 | $691.83 |
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 $251.19 Median $398.11 Typical High $616.60 | Professional | None | $251.19 | $398.11 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $138.04 Median $218.78 Typical High $269.15 | Professional | 52 · Reduced service | $138.04 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $87.10 Typical High $107.15 | Professional | 53 · Discontinued | $54.95 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $208.93 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $53.70 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $194.98 | $309.03 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $218.78 Typical High $263.03 | Professional | 52 · Reduced service | $138.04 | $218.78 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $87.10 Typical High $104.71 | Professional | 53 · Discontinued | $54.95 | $87.10 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $208.93 | $331.13 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $43.65 Typical High $52.48 | Professional | 56 · Pre-op care only | $27.54 | $43.65 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $194.98 | $309.03 | $371.54 |
Where Texas sits
The same service costs 5.1 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
$309
AK $1,585TX $309
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.