How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,413 to $14,791Professionalmedian $162 · 10th to 90th $23 to $813
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 $602.56 Median $676.08 Typical High $912.01 | Professional | None | $602.56 | $676.08 | $912.01 |
BCBS Texas Setting Facility Modifier None Typical Low $4,466.84 Median $9,772.37 Typical High $18,620.87 | Facility | None | $4,466.84 | $9,772.37 | $18,620.87 |
BCBS Texas Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,122.02 | Professional | None | $660.69 | $851.14 | $1,122.02 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,265.80 Typical High $6,025.60 | Facility | None | $691.83 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,148.15 | Professional | None | $660.69 | $812.83 | $1,148.15 |
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 $5,248.07 Median $5,248.07 Typical High $5,888.44 | Professional | None | $5,248.07 | $5,248.07 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $2,290.87 Typical High $6,025.60 | Facility | None | $660.69 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $891.25 | Professional | None | $602.56 | $676.08 | $891.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $120.23 Typical High $645.65 | Professional | None | $21.88 | $120.23 | $645.65 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $6,606.93 | Facility | None | $707.95 | $4,168.69 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,148.15 | Professional | None | $660.69 | $812.83 | $1,148.15 |
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 $562.34 Median $724.44 Typical High $1,122.02 | Professional | None | $562.34 | $724.44 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $302.00 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $154.88 | Professional | 53 · Discontinued | $120.23 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $446.68 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 52 · Reduced service | $302.00 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | 53 · Discontinued | $120.23 | $131.83 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $446.68 | $501.19 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 56 · Pre-op care only | $60.26 | $66.07 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $524.81 |
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
$380
AK $2,951TX $380
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.