How much rates vary
Facilitymedian $1,148 · 10th to 90th $151 to $3,715Professionalmedian $204 · 10th to 90th $28 to $347
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $302.00 | Professional | None | $147.91 | $234.42 | $302.00 |
BCBS Texas Setting Facility Modifier None Typical Low $616.60 Median $1,380.38 Typical High $3,801.89 | Facility | None | $616.60 | $1,380.38 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $380.19 | Professional | None | $162.18 | $251.19 | $380.19 |
Christus Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $1,659.59 | Facility | None | $457.09 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $371.54 | Professional | None | $186.21 | $263.03 | $371.54 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,949.84 | $1,949.84 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $1,000.00 Typical High $4,677.35 | Facility | None | $162.18 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $302.00 | Professional | None | $147.91 | $234.42 | $302.00 |
Molina Setting Professional Modifier None Typical Low $6.03 Median $43.65 Typical High $269.15 | Professional | None | $6.03 | $43.65 | $269.15 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $977.24 Typical High $3,801.89 | Facility | None | $263.03 | $977.24 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $371.54 | Professional | None | $181.97 | $263.03 | $371.54 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $338.84 | Professional | None | $147.91 | $218.78 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $72.44 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $72.44 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $29.51 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $109.65 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $21.88 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $102.33 | $165.96 | $199.53 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $72.44 | $117.49 | $141.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $29.51 | $46.77 | $56.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $109.65 | $177.83 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $21.88 | $35.48 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $28.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $102.33 | $165.96 | $199.53 |
Where Texas sits
The same service costs 4.1 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
$209
AK $851TX $209
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.