How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,413 to $7,244Professionalmedian $347 · 10th to 90th $52 to $1,862
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 $2,754.23 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,548.82 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,884.03 Typical High $7,244.36 | Facility | None | $1,412.54 | $2,884.03 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,905.46 | $2,691.53 |
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 $602.56 Median $2,041.74 Typical High $2,691.53 | Facility | None | $602.56 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,862.09 | $2,511.89 |
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 $12,022.64 Median $12,022.64 Typical High $13,489.63 | Professional | None | $12,022.64 | $12,022.64 | $13,489.63 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $5,623.41 | Facility | None | $724.44 | $2,344.23 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,584.89 | $2,089.30 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $269.15 Typical High $1,412.54 | Professional | None | $47.86 | $269.15 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $4,466.84 | Facility | None | $660.69 | $2,137.96 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,862.09 | $2,511.89 |
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 $1,288.25 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,584.89 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $707.95 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $309.03 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,047.13 | $1,148.15 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $154.88 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $977.24 | $1,071.52 | $1,230.27 |
Where Texas sits
The same service costs 7.8 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
$871
AK $6,761TX $871
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.