How much rates vary
Facilitymedian $2,455 · 10th to 90th $912 to $7,079Professionalmedian $209 · 10th to 90th $30 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 $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,000.00 | Professional | None | $741.31 | $812.83 | $1,000.00 |
BCBS Texas Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $6,309.57 | Facility | None | $912.01 | $2,187.76 | $6,309.57 |
BCBS Texas Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,348.96 | Professional | None | $776.25 | $977.24 | $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 $724.44 Median $977.24 Typical High $1,230.27 | Professional | None | $724.44 | $977.24 | $1,230.27 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $7,244.36 | Professional | None | $6,165.95 | $6,165.95 | $7,244.36 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $2,511.89 Typical High $6,760.83 | Facility | None | $794.33 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,071.52 | Professional | None | $741.31 | $812.83 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $147.91 Typical High $758.58 | Professional | None | $26.92 | $147.91 | $758.58 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $2,187.76 Typical High $6,760.83 | Facility | None | $851.14 | $2,187.76 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,230.27 | Professional | None | $724.44 | $977.24 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $1,230.27 | Professional | None | $630.96 | $776.25 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $371.54 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $398.11 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $162.18 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $602.56 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $660.69 |
Where Texas sits
The same service costs 7.2 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
$479
AK $3,467TX $479
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.