How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,072 to $6,918Professionalmedian $372 · 10th to 90th $25 to $759
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 $891.25 Median $3,630.78 Typical High $8,709.64 | Facility | None | $891.25 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $707.95 | Professional | None | $467.74 | $562.34 | $707.95 |
BCBS Texas Setting Facility Modifier None Typical Low $1,230.27 Median $2,691.53 Typical High $7,244.36 | Facility | None | $1,230.27 | $2,691.53 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,778.28 | Professional | None | $524.81 | $724.44 | $1,778.28 |
Christus Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,905.46 Typical High $3,311.31 | Facility | None | $870.96 | $1,905.46 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,000.00 | Professional | None | $549.54 | $691.83 | $1,000.00 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,623.41 | Professional | None | $4,677.35 | $4,677.35 | $5,623.41 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,513.56 Typical High $6,025.60 | Facility | None | $575.44 | $1,513.56 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $741.31 | Professional | None | $467.74 | $588.84 | $741.31 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $117.49 Typical High $602.56 | Professional | None | $21.38 | $117.49 | $602.56 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,949.84 Typical High $6,760.83 | Facility | None | $660.69 | $1,949.84 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,000.00 | Professional | None | $549.54 | $691.83 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $954.99 | Professional | None | $478.63 | $660.69 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $234.42 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $537.03 | Professional | 54 · Surgery only | $354.81 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $281.84 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $112.20 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $112.20 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $354.81 | $426.58 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $56.23 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $489.78 |
Where Texas sits
The same service costs 6.5 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
$407
AK $2,630TX $407
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.