How much rates vary
Facilitymedian $2,089 · 10th to 90th $427 to $5,370Professionalmedian $83 · 10th to 90th $11 to $468
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $524.81 | Professional | None | $346.74 | $380.19 | $524.81 |
BCBS Texas Setting Facility Modifier None Typical Low $2,238.72 Median $4,466.84 Typical High $9,332.54 | Facility | None | $2,238.72 | $4,466.84 | $9,332.54 |
BCBS Texas Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $660.69 | Professional | None | $389.05 | $489.78 | $660.69 |
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 $457.09 Median $1,905.46 Typical High $2,691.53 | Facility | None | $457.09 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $616.60 | Professional | None | $380.19 | $478.63 | $616.60 |
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 $3,019.95 Median $3,019.95 Typical High $3,467.37 | Professional | None | $3,019.95 | $3,019.95 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $1,778.28 Typical High $5,248.07 | Facility | None | $398.11 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $524.81 | Professional | None | $346.74 | $389.05 | $524.81 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $64.57 Typical High $371.54 | Professional | None | $10.96 | $64.57 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,479.11 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $1,905.46 Typical High $3,890.45 | Facility | None | $426.58 | $1,905.46 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $616.60 | Professional | None | $380.19 | $478.63 | $616.60 |
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 $316.23 Median $398.11 Typical High $616.60 | Professional | None | $316.23 | $398.11 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $173.78 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $263.03 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $309.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $190.55 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $190.55 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $69.18 | $75.86 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $288.40 Typical High $331.13 | Professional | 54 · Surgery only | $263.03 | $288.40 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $245.47 | $269.15 | $309.03 |
Where Texas sits
The same service costs 8.1 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 $1,698TX $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.