How much rates vary
Facilitymedian $2,089 · 10th to 90th $794 to $5,495Professionalmedian $324 · 10th to 90th $52 to $1,549
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 $1,230.27 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,230.27 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,348.96 | $1,698.24 |
BCBS Texas Setting Facility Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $5,495.41 | Facility | None | $1,348.96 | $2,344.23 | $5,495.41 |
BCBS Texas Setting Professional Modifier None Typical Low $1,318.26 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,819.70 | $2,344.23 |
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 $812.83 Median $1,148.15 Typical High $3,801.89 | Facility | None | $812.83 | $1,148.15 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,621.81 | $2,089.30 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $10,232.93 Median $10,232.93 Typical High $11,748.98 | Professional | None | $10,232.93 | $10,232.93 | $11,748.98 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,348.96 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $251.19 Typical High $1,202.26 | Professional | None | $47.86 | $251.19 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $7,585.78 | Facility | None | $912.01 | $1,412.54 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,621.81 | $2,089.30 |
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 $1,096.48 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,380.38 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $602.56 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $154.88 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $660.69 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $269.15 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $1,071.52 |
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
$347
AK $5,888TX $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.