How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,380 to $6,918Professionalmedian $166 · 10th to 90th $23 to $676
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $758.58 | Professional | None | $489.78 | $549.54 | $758.58 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,818.38 Typical High $6,309.57 | Facility | None | $1,412.54 | $2,818.38 | $6,309.57 |
BCBS Texas Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $933.25 | Professional | None | $549.54 | $691.83 | $933.25 |
Christus Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $3,388.44 | Facility | None | $602.56 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $933.25 | Professional | None | $549.54 | $676.08 | $933.25 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $6,606.93 Typical High $6,606.93 | Professional | None | $4,897.79 | $6,606.93 | $6,606.93 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $6,025.60 | Facility | None | $575.44 | $1,905.46 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $758.58 | Professional | None | $489.78 | $549.54 | $758.58 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $114.82 Typical High $524.81 | Professional | None | $21.88 | $114.82 | $524.81 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,398.83 Typical High $4,466.84 | Facility | None | $602.56 | $2,398.83 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $933.25 | Professional | None | $537.03 | $676.08 | $933.25 |
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 $457.09 Median $588.84 Typical High $912.01 | Professional | None | $457.09 | $588.84 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $245.47 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $245.47 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $436.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $275.42 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $109.65 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $61.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $436.52 |
Where Texas sits
The same service costs 7.9 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
$309
AK $2,455TX $309
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.