How much rates vary
Facilitymedian $1,230 · 10th to 90th $417 to $4,786Professionalmedian $355 · 10th to 90th $55 to $646
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $691.83 | Professional | None | $457.09 | $501.19 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $177.83 Median $1,318.26 Typical High $1,905.46 | Facility | None | $177.83 | $1,318.26 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $851.14 | Professional | None | $501.19 | $630.96 | $851.14 |
Christus Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $537.03 Typical High $2,691.53 | Facility | None | $398.11 | $537.03 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $812.83 | Professional | None | $501.19 | $616.60 | $812.83 |
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 $4,365.16 Median $4,365.16 Typical High $4,466.84 | Professional | None | $4,365.16 | $4,365.16 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $2,290.87 Typical High $6,025.60 | Facility | None | $549.54 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $691.83 | Professional | None | $457.09 | $512.86 | $691.83 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $275.42 Typical High $478.63 | Professional | None | $53.70 | $275.42 | $478.63 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $707.95 Typical High $6,165.95 | Facility | None | $457.09 | $707.95 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $831.76 | Professional | None | $501.19 | $616.60 | $831.76 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $831.76 | Professional | None | $416.87 | $537.03 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $229.09 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $371.54 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $75.86 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $75.86 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $398.11 |
Where Texas sits
The same service costs 6.3 times more in Alaska than in Utah. 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· 50th of 51
$363
AK $2,239UT $355
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.