How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,202 to $9,772Professionalmedian $214 · 10th to 90th $35 to $1,072
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 $1,023.29 Median $3,801.89 Typical High $10,232.93 | Facility | None | $1,023.29 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,288.25 | Professional | None | $870.96 | $954.99 | $1,288.25 |
BCBS Texas Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,621.81 | Professional | None | $954.99 | $1,202.26 | $1,621.81 |
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 $794.33 Median $2,041.74 Typical High $2,754.23 | Facility | None | $794.33 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,584.89 | Professional | None | $912.01 | $1,174.90 | $1,584.89 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $6,918.31 | Facility | None | $933.25 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,258.93 | Professional | None | $870.96 | $977.24 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $169.82 Typical High $851.14 | Professional | None | $32.36 | $169.82 | $851.14 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $2,041.74 Typical High $2,754.23 | Facility | None | $870.96 | $2,041.74 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,584.89 | Professional | None | $912.01 | $1,174.90 | $1,584.89 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $436.52 Median $478.63 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $831.76 | Professional | 54 · Surgery only | $645.65 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $478.63 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $478.63 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $190.55 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $724.44 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $724.44 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $676.08 | $758.58 |
Where Texas sits
The same service costs 18.2 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
$234
AK $4,266TX $234
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.