How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,000 to $7,586Professionalmedian $123 · 10th to 90th $18 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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $724.44 | Professional | None | $478.63 | $524.81 | $724.44 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $4,466.84 Typical High $8,128.31 | Facility | None | $2,041.74 | $4,466.84 | $8,128.31 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $891.25 | Professional | None | $524.81 | $660.69 | $891.25 |
Christus Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,630.27 Typical High $3,715.35 | Facility | None | $602.56 | $2,630.27 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $870.96 | Professional | None | $512.86 | $645.65 | $870.96 |
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 $4,265.80 Median $4,265.80 Typical High $4,677.35 | Professional | None | $4,265.80 | $4,265.80 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,905.46 Typical High $5,495.41 | Facility | None | $562.34 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $707.95 | Professional | None | $478.63 | $537.03 | $707.95 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $93.33 Typical High $489.78 | Professional | None | $16.22 | $93.33 | $489.78 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $2,691.53 Typical High $4,466.84 | Facility | None | $575.44 | $2,691.53 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $870.96 | Professional | None | $512.86 | $645.65 | $870.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $870.96 | Professional | None | $436.52 | $562.34 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $239.88 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $457.09 | Professional | 54 · Surgery only | $354.81 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $263.03 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $104.71 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $389.05 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $77.62 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $363.08 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $331.13 | $363.08 | $416.87 |
Where Texas sits
The same service costs 7.9 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
$295
AK $2,344TX $295
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.