How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,000 to $6,918Professionalmedian $115 · 10th to 90th $17 to $646
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 $478.63 Median $537.03 Typical High $831.76 | Professional | None | $478.63 | $537.03 | $831.76 |
BCBS Texas Setting Facility Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $9,772.37 | Facility | None | $2,691.53 | $5,011.87 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,000.00 | Professional | None | $537.03 | $676.08 | $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 $524.81 Median $660.69 Typical High $891.25 | Professional | None | $524.81 | $660.69 | $891.25 |
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 $4,168.69 Median $4,168.69 Typical High $4,786.30 | Professional | None | $4,168.69 | $4,168.69 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $2,398.83 Typical High $6,025.60 | Facility | None | $549.54 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $831.76 | Professional | None | $478.63 | $537.03 | $831.76 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $93.33 Typical High $501.19 | Professional | None | $16.22 | $93.33 | $501.19 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $6,165.95 | Facility | None | $645.65 | $2,137.96 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $891.25 | Professional | None | $524.81 | $660.69 | $891.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $870.96 | Professional | None | $446.68 | $562.34 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $239.88 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $426.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $263.03 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $104.71 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $398.11 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $60.26 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $338.84 | $371.54 | $426.58 |
Where Texas sits
The same service costs 8.9 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
$263
AK $2,344TX $263
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.