How much rates vary
Facilitymedian $5,623 · 10th to 90th $2,344 to $13,183Professionalmedian $234 · 10th to 90th $35 to $1,072
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 $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
BCBS Texas Setting Facility Modifier None Typical Low $3,090.30 Median $6,309.57 Typical High $15,488.17 | Facility | None | $3,090.30 | $6,309.57 | $15,488.17 |
BCBS Texas Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,479.11 | Professional | None | $870.96 | $1,096.48 | $1,479.11 |
Christus Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $5,370.32 Typical High $7,585.78 | Facility | None | $954.99 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,548.82 | Professional | None | $870.96 | $1,071.52 | $1,548.82 |
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 $7,079.46 Median $7,079.46 Typical High $7,585.78 | Professional | None | $7,079.46 | $7,079.46 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $2,511.89 Typical High $6,918.31 | Facility | None | $870.96 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,148.15 | Professional | None | $794.33 | $891.25 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $165.96 Typical High $794.33 | Professional | None | $32.36 | $165.96 | $794.33 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $933.25 | $5,370.32 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,513.56 | Professional | None | $870.96 | $1,071.52 | $1,513.56 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,309.57 | $15,135.61 |
United Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,479.11 | Professional | None | $741.31 | $954.99 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $398.11 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $436.52 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $173.78 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $660.69 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $691.83 |
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
$490
AK $3,890TX $490
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.