How much rates vary
Facilitymedian $2,042 · 10th to 90th $676 to $4,467Professionalmedian $151 · 10th to 90th $23 to $724
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $812.83 | Professional | None | $524.81 | $588.84 | $812.83 |
BCBS Texas Setting Facility Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $5,248.07 | Facility | None | $1,348.96 | $2,398.83 | $5,248.07 |
BCBS Texas Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,000.00 | Professional | None | $588.84 | $741.31 | $1,000.00 |
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 $602.56 Median $1,122.02 Typical High $2,089.30 | Facility | None | $602.56 | $1,122.02 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $954.99 | Professional | None | $575.44 | $724.44 | $954.99 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,248.07 | Professional | None | $4,897.79 | $4,897.79 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,905.46 Typical High $5,495.41 | Facility | None | $588.84 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $776.25 | Professional | None | $524.81 | $588.84 | $776.25 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $112.20 Typical High $549.54 | Professional | None | $21.88 | $112.20 | $549.54 |
Oscar Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $2,290.87 | Professional | None | $2,137.96 | $2,187.76 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,202.26 Typical High $4,466.84 | Facility | None | $602.56 | $1,202.26 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $954.99 | Professional | None | $575.44 | $724.44 | $954.99 |
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 $446.68 Median $616.60 Typical High $891.25 | Professional | None | $446.68 | $616.60 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $263.03 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $104.71 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $288.40 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $104.71 | $117.49 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $436.52 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $52.48 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $467.74 |
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
$347
AK $2,570TX $347
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.