How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,698 to $12,023Professionalmedian $170 · 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 $512.86 Median $562.34 Typical High $776.25 | Professional | None | $512.86 | $562.34 | $776.25 |
BCBS Texas Setting Facility Modifier None Typical Low $3,090.30 Median $6,025.60 Typical High $15,135.61 | Facility | None | $3,090.30 | $6,025.60 | $15,135.61 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $954.99 | Professional | None | $562.34 | $707.95 | $954.99 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,265.80 Typical High $6,025.60 | Facility | None | $691.83 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $954.99 | Professional | None | $562.34 | $691.83 | $954.99 |
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 $5,370.32 Typical High $5,370.32 | Professional | None | $5,011.87 | $5,370.32 | $5,370.32 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $6,025.60 | Facility | None | $602.56 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $776.25 | Professional | None | $512.86 | $575.44 | $776.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $114.82 Typical High $524.81 | Professional | None | $21.88 | $114.82 | $524.81 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $4,168.69 Typical High $6,606.93 | Facility | None | $660.69 | $4,168.69 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $954.99 | Professional | None | $549.54 | $691.83 | $954.99 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,232.93 | Facility | None | $1,698.24 | $4,570.88 | $10,232.93 |
United Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $933.25 | Professional | None | $467.74 | $602.56 | $933.25 |
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 $257.04 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $489.78 | Professional | 54 · Surgery only | $380.19 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $457.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $112.20 | $128.82 |
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 $85.11 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $56.23 | $64.57 |
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 8.1 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
$309
AK $2,512TX $309
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.