How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,380 to $7,586Professionalmedian $200 · 10th to 90th $30 to $977
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 $707.95 Median $794.33 Typical High $1,071.52 | Professional | None | $707.95 | $794.33 | $1,071.52 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,951.21 Typical High $7,244.36 | Facility | None | $1,412.54 | $2,951.21 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,318.26 | Professional | None | $794.33 | $1,000.00 | $1,318.26 |
Christus Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,570.40 Typical High $3,388.44 | Facility | None | $691.83 | $2,570.40 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,380.38 | Professional | None | $794.33 | $977.24 | $1,380.38 |
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 $6,165.95 Median $6,165.95 Typical High $6,918.31 | Professional | None | $6,165.95 | $6,165.95 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,398.83 Typical High $6,025.60 | Facility | None | $758.58 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,023.29 | Professional | None | $707.95 | $794.33 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $144.54 Typical High $707.95 | Professional | None | $26.92 | $144.54 | $707.95 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $6,165.95 | Facility | None | $758.58 | $2,630.27 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,348.96 | Professional | None | $776.25 | $977.24 | $1,348.96 |
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 $660.69 Median $851.14 Typical High $1,318.26 | Professional | None | $660.69 | $851.14 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $354.81 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $389.05 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $141.25 | $158.49 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $588.84 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $70.79 | $79.43 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $630.96 |
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
$437
AK $3,467TX $437
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.