How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,122 to $11,220Professionalmedian $234 · 10th to 90th $35 to $1,148
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 $1,047.13 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,047.13 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,202.26 | Professional | None | $831.76 | $933.25 | $1,202.26 |
BCBS Texas Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,584.89 | Professional | None | $933.25 | $1,174.90 | $1,584.89 |
Christus Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $7,762.47 Typical High $10,964.78 | Facility | None | $954.99 | $7,762.47 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,621.81 | Professional | None | $933.25 | $1,148.15 | $1,621.81 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $8,128.31 | Professional | None | $7,585.78 | $7,585.78 | $8,128.31 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $2,511.89 Typical High $6,918.31 | Facility | None | $912.01 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,202.26 | Professional | None | $831.76 | $933.25 | $1,202.26 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $169.82 Typical High $851.14 | Professional | None | $32.36 | $169.82 | $851.14 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $7,413.10 Typical High $10,964.78 | Facility | None | $933.25 | $7,413.10 | $10,964.78 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,621.81 | Professional | None | $912.01 | $1,148.15 | $1,621.81 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,309.57 | $15,848.93 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,548.82 | Professional | None | $776.25 | $1,000.00 | $1,548.82 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $416.87 Median $457.09 Typical High $537.03 | Professional | 52 · Reduced service | $416.87 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $457.09 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $165.96 | $186.21 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $630.96 | $691.83 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $741.31 |
Where Texas sits
The same service costs 8.5 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
$479
AK $4,074TX $479
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.