How much rates vary
Facilitymedian $2,512 · 10th to 90th $977 to $6,607Professionalmedian $174 · 10th to 90th $23 to $977
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 $1,000.00 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,023.29 | Professional | None | $724.44 | $794.33 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,884.03 Typical High $6,760.83 | Facility | None | $1,412.54 | $2,884.03 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,348.96 | Professional | None | $794.33 | $1,000.00 | $1,348.96 |
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 $870.96 Median $2,041.74 Typical High $3,311.31 | Facility | None | $870.96 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,318.26 | Professional | None | $794.33 | $977.24 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,079.46 | Professional | None | $6,760.83 | $6,760.83 | $7,079.46 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $2,454.71 Typical High $6,918.31 | Facility | None | $794.33 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,071.52 | Professional | None | $724.44 | $794.33 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $128.82 Typical High $758.58 | Professional | None | $21.88 | $128.82 | $758.58 |
Providence Setting Facility Modifier None Typical Low $831.76 Median $2,187.76 Typical High $7,079.46 | Facility | None | $831.76 | $2,187.76 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,318.26 | Professional | None | $794.33 | $977.24 | $1,318.26 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,890.45 | Facility | None | $616.60 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,318.26 | Professional | None | $676.08 | $851.14 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $363.08 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $398.11 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $158.49 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $158.49 | $181.97 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $602.56 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $107.15 | $120.23 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $79.43 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $79.43 | $91.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $630.96 |
Where Texas sits
The same service costs 7.1 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
$501
AK $3,548TX $501
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.