How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,072 to $10,233Professionalmedian $107 · 10th to 90th $17 to $501
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 $1,000.00 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $630.96 | Professional | None | $416.87 | $457.09 | $630.96 |
BCBS Texas Setting Facility Modifier None Typical Low $4,466.84 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,466.84 | $8,128.31 | $16,982.44 |
BCBS Texas Setting Professional Modifier None Typical Low $457.09 Median $758.58 Typical High $1,230.27 | Professional | None | $457.09 | $758.58 | $1,230.27 |
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 $467.74 Median $549.54 Typical High $870.96 | Professional | None | $467.74 | $549.54 | $870.96 |
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 $6,165.95 Median $6,165.95 Typical High $6,165.95 | Professional | None | $6,165.95 | $6,165.95 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $2,511.89 Typical High $6,918.31 | Facility | None | $524.81 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $616.60 | Professional | None | $416.87 | $457.09 | $616.60 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $87.10 Typical High $407.38 | Professional | None | $16.60 | $87.10 | $407.38 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $7,585.78 | Facility | None | $758.58 | $3,715.35 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $870.96 | Professional | None | $457.09 | $549.54 | $870.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $831.76 | Professional | None | $426.58 | $549.54 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $204.17 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $309.03 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $204.17 | $223.87 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $331.13 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $331.13 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $309.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $309.03 | $363.08 |
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
$110
AK $1,995TX $110
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.