How much rates vary
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 $741.31 Median $831.76 Typical High $1,071.52 | Professional | None | $741.31 | $831.76 | $1,071.52 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $10,232.93 | Facility | None | $2,630.27 | $4,786.30 | $10,232.93 |
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 $691.83 Median $2,089.30 Typical High $2,754.23 | Facility | None | $691.83 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $776.25 | $1,000.00 | $1,288.25 |
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 $6,309.57 Median $6,309.57 Typical High $7,413.10 | Professional | None | $6,309.57 | $6,309.57 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $2,290.87 Typical High $6,025.60 | Facility | None | $794.33 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,096.48 | Professional | None | $741.31 | $831.76 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $151.36 Typical High $758.58 | Professional | None | $26.92 | $151.36 | $758.58 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $6,165.95 | Facility | None | $758.58 | $2,137.96 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,288.25 | Professional | None | $776.25 | $1,000.00 | $1,288.25 |
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 $645.65 Median $831.76 Typical High $1,288.25 | Professional | None | $645.65 | $831.76 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $162.18 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $123.03 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $575.44 | $660.69 |
Where Texas sits
The same service costs 7.9 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
$447
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.