How much rates vary
Facilitymedian $2,630 · 10th to 90th $794 to $6,918Professionalmedian $83 · 10th to 90th $11 to $479
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $537.03 | Professional | None | $354.81 | $389.05 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $2,570.40 Median $4,677.35 Typical High $9,772.37 | Facility | None | $2,570.40 | $4,677.35 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $660.69 | Professional | None | $389.05 | $501.19 | $660.69 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,905.46 Typical High $2,691.53 | Facility | None | $457.09 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $645.65 | Professional | None | $389.05 | $489.78 | $645.65 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,548.13 | Professional | None | $3,162.28 | $3,162.28 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,778.28 Typical High $5,495.41 | Facility | None | $426.58 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $537.03 | Professional | None | $354.81 | $398.11 | $537.03 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $64.57 Typical High $371.54 | Professional | None | $10.96 | $64.57 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,479.11 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,479.11 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,905.46 Typical High $3,890.45 | Facility | None | $426.58 | $1,905.46 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $645.65 | Professional | None | $389.05 | $489.78 | $645.65 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $645.65 | Professional | None | $323.59 | $416.87 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $177.83 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $70.79 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $177.83 | $194.98 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $70.79 | $77.62 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | 54 · Surgery only | $269.15 | $295.12 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $44.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $251.19 | $275.42 | $316.23 |
Where Texas sits
The same service costs 8.3 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
$209
AK $1,738TX $209
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.