How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,072 to $6,457Professionalmedian $209 · 10th to 90th $13 to $417
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 $707.95 Median $2,754.23 Typical High $6,918.31 | Facility | None | $707.95 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $398.11 | Professional | None | $199.53 | $316.23 | $398.11 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $7,079.46 | Facility | None | $1,412.54 | $2,754.23 | $7,079.46 |
BCBS Texas Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $457.09 | Professional | None | $218.78 | $331.13 | $457.09 |
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 $602.56 Median $2,041.74 Typical High $2,691.53 | Facility | None | $602.56 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $512.86 | Professional | None | $251.19 | $363.08 | $512.86 |
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 $2,630.27 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,630.27 | $2,630.27 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $1,148.15 Typical High $4,786.30 | Facility | None | $275.42 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $398.11 | Professional | None | $199.53 | $316.23 | $398.11 |
Molina Setting Professional Modifier None Typical Low $10.23 Median $58.88 Typical High $302.00 | Professional | None | $10.23 | $58.88 | $302.00 |
Providence Setting Facility Modifier None Typical Low $363.08 Median $1,995.26 Typical High $4,466.84 | Facility | None | $363.08 | $1,995.26 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $512.86 | Professional | None | $245.47 | $354.81 | $512.86 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $478.63 | Professional | None | $194.98 | $309.03 | $478.63 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $97.72 Median $158.49 Typical High $199.53 | Professional | 52 · Reduced service | $97.72 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $79.43 | Professional | 53 · Discontinued | $39.81 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $295.12 | Professional | 54 · Surgery only | $147.91 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $46.77 Typical High $58.88 | Professional | 55 · Aftercare only | $29.51 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $218.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $138.04 | $218.78 | $275.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $97.72 | $158.49 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $39.81 | $63.10 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $147.91 | $234.42 | $281.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $29.51 | $46.77 | $56.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $19.95 | $31.62 | $38.02 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $138.04 | $218.78 | $263.03 |
Where Texas sits
The same service costs 5.5 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
$219
AK $1,202TX $219
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.