How much rates vary
Facilitymedian $1,950 · 10th to 90th $646 to $4,365Professionalmedian $389 · 10th to 90th $23 to $794
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 $707.95 Median $2,630.27 Typical High $6,918.31 | Facility | None | $707.95 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $794.33 | Professional | None | $512.86 | $630.96 | $794.33 |
BCBS Texas Setting Facility Modifier None Typical Low $1,230.27 Median $2,344.23 Typical High $4,677.35 | Facility | None | $1,230.27 | $2,344.23 | $4,677.35 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,548.82 | Professional | None | $562.34 | $794.33 | $1,548.82 |
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 $588.84 Median $851.14 Typical High $1,862.09 | Facility | None | $588.84 | $851.14 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,000.00 | Professional | None | $588.84 | $741.31 | $1,000.00 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,165.95 | Professional | None | $5,128.61 | $5,128.61 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,148.15 Typical High $4,786.30 | Facility | None | $562.34 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $794.33 | Professional | None | $512.86 | $645.65 | $794.33 |
Molina Setting Professional Modifier None Typical Low $20.89 Median $120.23 Typical High $645.65 | Professional | None | $20.89 | $120.23 | $645.65 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $4,466.84 | Facility | None | $575.44 | $933.25 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,000.00 | Professional | None | $562.34 | $741.31 | $1,000.00 |
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 $478.63 Median $630.96 Typical High $933.25 | Professional | None | $478.63 | $630.96 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $257.04 Median $309.03 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $588.84 | Professional | 54 · Surgery only | $389.05 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $117.49 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $257.04 | $309.03 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $104.71 | $125.89 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $389.05 | $467.74 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $77.62 | $93.33 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $51.29 | $63.10 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $363.08 | $436.52 | $524.81 |
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
$427
AK $2,399TX $427
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.