How much rates vary
Facilitymedian $1,905 · 10th to 90th $646 to $4,169Professionalmedian $129 · 10th to 90th $18 to $575
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $616.60 | Professional | None | $416.87 | $457.09 | $616.60 |
BCBS Texas Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $5,011.87 | Facility | None | $1,348.96 | $2,454.71 | $5,011.87 |
BCBS Texas Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $794.33 | Professional | None | $467.74 | $588.84 | $794.33 |
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 $457.09 Median $1,071.52 Typical High $1,659.59 | Facility | None | $457.09 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $741.31 | Professional | None | $457.09 | $575.44 | $741.31 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,168.69 | Professional | None | $3,630.78 | $3,630.78 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,819.70 Typical High $5,248.07 | Facility | None | $467.74 | $1,819.70 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $630.96 | Professional | None | $416.87 | $467.74 | $630.96 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $89.13 Typical High $446.68 | Professional | None | $16.22 | $89.13 | $446.68 |
Oscar Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $1,819.70 | Professional | None | $1,698.24 | $1,737.80 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $1,122.02 Typical High $3,801.89 | Facility | None | $467.74 | $1,122.02 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $741.31 | Professional | None | $457.09 | $575.44 | $741.31 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $741.31 | Professional | None | $380.19 | $478.63 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $208.93 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $371.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $208.93 | $229.09 | $263.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $83.18 | $91.20 | $104.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $346.74 | $398.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $69.18 Typical High $79.43 | Professional | 55 · Aftercare only | $63.10 | $69.18 | $79.43 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $52.48 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $323.59 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $323.59 | $371.54 |
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
$269
AK $2,042TX $269
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.