How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,259 to $10,000Professionalmedian $295 · 10th to 90th $46 to $1,318
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 $1,122.02 Median $3,801.89 Typical High $10,232.93 | Facility | None | $1,122.02 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,122.02 | $1,479.11 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $2,398.83 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,398.83 | $8,709.64 |
BCBS Texas Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,380.38 | $1,862.09 |
Christus Setting Facility Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Facility | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $5,495.41 Typical High $7,762.47 | Facility | None | $794.33 | $5,495.41 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,380.38 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
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 $1,000.00 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,148.15 | $1,479.11 |
Molina Setting Professional Modifier None Typical Low $42.66 Median $218.78 Typical High $1,023.29 | Professional | None | $42.66 | $218.78 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $5,370.32 Typical High $7,762.47 | Facility | None | $933.25 | $5,370.32 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,380.38 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,165.95 | $15,135.61 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,905.46 | Professional | None | $954.99 | $1,230.27 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
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 $501.19 Median $562.34 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $912.01 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $562.34 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $562.34 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $223.87 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $831.76 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $112.20 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $112.20 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $776.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $776.25 | $891.25 |
Where Texas sits
The same service costs 8.7 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
$575
AK $5,012TX $575
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.