How much rates vary
Facilitymedian $1,380 · 10th to 90th $589 to $4,467Professionalmedian $324 · 10th to 90th $46 to $603
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 $891.25 Median $3,630.78 Typical High $8,709.64 | Facility | None | $891.25 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $562.34 | Professional | None | $309.03 | $446.68 | $562.34 |
BCBS Texas Setting Facility Modifier None Typical Low $616.60 Median $1,445.44 Typical High $3,981.07 | Facility | None | $616.60 | $1,445.44 | $3,981.07 |
BCBS Texas Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $776.25 | Professional | None | $338.84 | $478.63 | $776.25 |
Christus Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $977.24 Typical High $2,818.38 | Facility | None | $707.95 | $977.24 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $724.44 | Professional | None | $389.05 | $537.03 | $724.44 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,365.16 | Professional | None | $3,801.89 | $3,801.89 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $6,025.60 | Facility | None | $446.68 | $1,479.11 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $562.34 | Professional | None | $309.03 | $446.68 | $562.34 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $91.20 Typical High $478.63 | Professional | None | $16.22 | $91.20 | $478.63 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,023.29 Typical High $6,760.83 | Facility | None | $537.03 | $1,023.29 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $724.44 | Professional | None | $389.05 | $537.03 | $724.44 |
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 $309.03 Median $446.68 Typical High $676.08 | Professional | None | $309.03 | $446.68 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $154.88 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $154.88 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $61.66 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $46.77 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $218.78 | $316.23 | $380.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $154.88 | $223.87 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $61.66 | $89.13 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $338.84 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $46.77 | $67.61 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $30.90 | $44.67 | $53.70 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $218.78 | $316.23 | $380.19 |
Where Texas sits
The same service costs 4.8 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
$339
AK $1,549UT $324
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.