How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,259 to $12,303Professionalmedian $162 · 10th to 90th $23 to $955
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 $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,047.13 | Professional | None | $691.83 | $776.25 | $1,047.13 |
BCBS Texas Setting Facility Modifier None Typical Low $5,128.61 Median $9,772.37 Typical High $20,892.96 | Facility | None | $5,128.61 | $9,772.37 | $20,892.96 |
BCBS Texas Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,318.26 | Professional | None | $776.25 | $977.24 | $1,318.26 |
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 $870.96 Median $4,265.80 Typical High $6,025.60 | Facility | None | $870.96 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,318.26 | Professional | None | $758.58 | $954.99 | $1,318.26 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,760.83 | Professional | None | $6,025.60 | $6,025.60 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $2,511.89 Typical High $6,760.83 | Facility | None | $776.25 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,023.29 | Professional | None | $691.83 | $776.25 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $128.82 Typical High $724.44 | Professional | None | $21.88 | $128.82 | $724.44 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $4,265.80 Typical High $7,244.36 | Facility | None | $831.76 | $4,265.80 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,318.26 | Professional | None | $758.58 | $954.99 | $1,318.26 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,288.25 | Professional | None | $645.65 | $831.76 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $346.74 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $389.05 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $389.05 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $154.88 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $575.44 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $616.60 |
Where Texas sits
The same service costs 7.6 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
$447
AK $3,388TX $447
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.