How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,380 to $12,303Professionalmedian $288 · 10th to 90th $46 to $1,514
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 $1,202.26 Median $3,311.31 Typical High $8,709.64 | Facility | None | $1,202.26 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,318.26 | $1,698.24 |
BCBS Texas Setting Facility Modifier None Typical Low $5,495.41 Median $10,000.00 Typical High $20,892.96 | Facility | None | $5,495.41 | $10,000.00 | $20,892.96 |
BCBS Texas Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,778.28 | $2,454.71 |
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 $1,288.25 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,584.89 | $2,187.76 |
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 $10,000.00 Median $10,000.00 Typical High $11,481.54 | Professional | None | $10,000.00 | $10,000.00 | $11,481.54 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $6,025.60 | Facility | None | $933.25 | $2,511.89 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,318.26 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $234.42 Typical High $1,174.90 | Professional | None | $41.69 | $234.42 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $4,168.69 Typical High $6,606.93 | Facility | None | $758.58 | $4,168.69 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,584.89 | $2,187.76 |
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 $1,071.52 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,380.38 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $588.84 Median $645.65 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $645.65 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $645.65 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $234.42 | $257.04 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,122.02 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $223.87 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,047.13 |
Where Texas sits
The same service costs 17.0 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
$331
AK $5,623TX $331
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.