How much rates vary
Facilitymedian $1,622 · 10th to 90th $617 to $3,981Professionalmedian $288 · 10th to 90th $26 to $537
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 $263.03 Median $398.11 Typical High $501.19 | Professional | None | $263.03 | $398.11 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | None | $269.15 | $269.15 | $288.40 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $3,801.89 | Facility | None | $691.83 | $1,445.44 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $676.08 | Professional | None | $288.40 | $416.87 | $676.08 |
Christus Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $630.96 | Professional | None | $331.13 | $457.09 | $630.96 |
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 $3,311.31 Median $3,311.31 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,311.31 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $1,288.25 Typical High $5,495.41 | Facility | None | $398.11 | $1,288.25 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $501.19 | Professional | None | $263.03 | $398.11 | $501.19 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $85.11 Typical High $416.87 | Professional | None | $16.60 | $85.11 | $416.87 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $1,000.00 Typical High $4,466.84 | Facility | None | $446.68 | $1,000.00 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $630.96 | Professional | None | $331.13 | $457.09 | $630.96 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $263.03 Median $389.05 Typical High $588.84 | Professional | None | $263.03 | $389.05 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
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 $131.83 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $131.83 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $52.48 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $194.98 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $38.90 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.30 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $181.97 | $275.42 | $338.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $199.53 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $52.48 | $79.43 | $95.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $295.12 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $295.12 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $58.88 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.30 | $39.81 | $47.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $275.42 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $181.97 | $275.42 | $331.13 |
Where Texas sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 50th of 51
$302
AK $1,413UT $288
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.