How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,413 to $8,318Professionalmedian $468 · 10th to 90th $30 to $1,122
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 $3,311.31 Typical High $8,709.64 | Facility | None | $1,000.00 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,258.93 | Professional | None | $831.76 | $933.25 | $1,258.93 |
BCBS Texas Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,691.53 | $4,786.30 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,513.56 | Professional | None | $912.01 | $1,122.02 | $1,513.56 |
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 $707.95 Median $2,089.30 Typical High $2,754.23 | Facility | None | $707.95 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,584.89 | Professional | None | $933.25 | $1,122.02 | $1,584.89 |
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 $7,413.10 Median $7,413.10 Typical High $7,585.78 | Professional | None | $7,413.10 | $7,413.10 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,025.60 | Facility | None | $831.76 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,230.27 | Professional | None | $831.76 | $954.99 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $158.49 Typical High $851.14 | Professional | None | $27.54 | $158.49 | $851.14 |
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 $912.01 Median $1,122.02 Typical High $1,584.89 | Professional | None | $912.01 | $1,122.02 | $1,584.89 |
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 $776.25 Median $1,000.00 Typical High $1,513.56 | Professional | None | $776.25 | $1,000.00 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $416.87 Median $457.09 Typical High $537.03 | Professional | 52 · Reduced service | $416.87 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $630.96 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $107.15 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $416.87 | $457.09 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $208.93 | Professional | 53 · Discontinued | $165.96 | $181.97 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $691.83 Typical High $776.25 | Professional | 54 · Surgery only | $630.96 | $691.83 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $138.04 Typical High $154.88 | Professional | 55 · Aftercare only | $125.89 | $138.04 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $645.65 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $588.84 | $645.65 | $724.44 |
Where Texas sits
The same service costs 7.6 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
$525
AK $3,981TX $525
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.