How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,380 to $7,079Professionalmedian $174 · 10th to 90th $23 to $708
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 $524.81 Median $575.44 Typical High $794.33 | Professional | None | $524.81 | $575.44 | $794.33 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $6,606.93 | Facility | None | $1,412.54 | $2,754.23 | $6,606.93 |
BCBS Texas Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,000.00 | Professional | None | $575.44 | $741.31 | $1,000.00 |
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 $691.83 Median $2,089.30 Typical High $2,754.23 | Facility | None | $691.83 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $954.99 | Professional | None | $575.44 | $707.95 | $954.99 |
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 $4,677.35 Median $4,677.35 Typical High $5,128.61 | Professional | None | $4,677.35 | $4,677.35 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $2,290.87 Typical High $6,025.60 | Facility | None | $616.60 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $794.33 | Professional | None | $524.81 | $588.84 | $794.33 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $114.82 Typical High $537.03 | Professional | None | $21.88 | $114.82 | $537.03 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $6,165.95 | Facility | None | $660.69 | $2,137.96 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $954.99 | Professional | None | $575.44 | $707.95 | $954.99 |
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 $489.78 Median $616.60 Typical High $954.99 | Professional | None | $489.78 | $616.60 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $263.03 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $389.05 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $288.40 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $114.82 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $436.52 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $436.52 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $407.38 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $363.08 | $407.38 | $457.09 |
Where Texas sits
The same service costs 7.8 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
$331
AK $2,570TX $331
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.