How much rates vary
Facilitymedian $2,138 · 10th to 90th $977 to $5,495Professionalmedian $162 · 10th to 90th $23 to $692
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 $501.19 Median $562.34 Typical High $741.31 | Professional | None | $501.19 | $562.34 | $741.31 |
BCBS Texas Setting Facility Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,122.02 | $2,089.30 | $4,265.80 |
BCBS Texas Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $933.25 | Professional | None | $549.54 | $707.95 | $933.25 |
Christus Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,691.53 | Facility | None | $691.83 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,000.00 | Professional | None | $549.54 | $691.83 | $1,000.00 |
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 $5,011.87 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,011.87 | $5,495.41 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $6,025.60 | Facility | None | $602.56 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $741.31 | Professional | None | $501.19 | $562.34 | $741.31 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $112.20 Typical High $512.86 | Professional | None | $21.88 | $112.20 | $512.86 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $6,165.95 | Facility | None | $660.69 | $1,258.93 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $1,000.00 | Professional | None | $549.54 | $691.83 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $954.99 | Professional | None | $467.74 | $616.60 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $251.19 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $109.65 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Where Texas sits
The same service costs 7.4 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
$331
AK $2,455TX $331
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.