How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,230 to $19,498Professionalmedian $234 · 10th to 90th $35 to $1,047
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 $758.58 Median $870.96 Typical High $1,148.15 | Professional | None | $758.58 | $870.96 | $1,148.15 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
BCBS Texas Setting Facility Modifier None Typical Low $8,912.51 Median $19,498.45 Typical High $38,904.51 | Facility | None | $8,912.51 | $19,498.45 | $38,904.51 |
BCBS Texas Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,479.11 | Professional | None | $851.14 | $1,071.52 | $1,479.11 |
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 $691.83 Median $7,762.47 Typical High $10,964.78 | Facility | None | $691.83 | $7,762.47 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,513.56 | Professional | None | $851.14 | $1,047.13 | $1,513.56 |
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 $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $5,623.41 | Facility | None | $812.83 | $2,290.87 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,096.48 | Professional | None | $758.58 | $870.96 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $165.96 Typical High $776.25 | Professional | None | $32.36 | $165.96 | $776.25 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $6,165.95 Typical High $10,000.00 | Facility | None | $758.58 | $6,165.95 | $10,000.00 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,513.56 | Professional | None | $831.76 | $1,047.13 | $1,513.56 |
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 $707.95 Median $954.99 Typical High $1,479.11 | Professional | None | $707.95 | $954.99 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $380.19 Median $426.58 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $380.19 | $426.58 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $169.82 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $630.96 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $676.08 |
Where Texas sits
The same service costs 7.9 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
$468
AK $3,715TX $468
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.