How much rates vary
Facilitymedian $3,162 · 10th to 90th $933 to $7,079Professionalmedian $417 · 10th to 90th $28 to $759
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 $407.38 Median $562.34 Typical High $707.95 | Professional | None | $407.38 | $562.34 | $707.95 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $9,549.93 | Facility | None | $2,630.27 | $5,011.87 | $9,549.93 |
BCBS Texas Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $831.76 | Professional | None | $446.68 | $616.60 | $831.76 |
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 $870.96 Median $2,041.74 Typical High $3,311.31 | Facility | None | $870.96 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $912.01 | Professional | None | $512.86 | $691.83 | $912.01 |
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 $4,786.30 Median $4,786.30 Typical High $5,495.41 | Professional | None | $4,786.30 | $4,786.30 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $6,025.60 | Facility | None | $537.03 | $1,659.59 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $562.34 Typical High $707.95 | Professional | None | $407.38 | $562.34 | $707.95 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $602.56 | Professional | None | $21.88 | $117.49 | $602.56 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,089.30 Typical High $6,760.83 | Facility | None | $660.69 | $2,089.30 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $912.01 | Professional | None | $512.86 | $691.83 | $912.01 |
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 $407.38 Median $588.84 Typical High $891.25 | Professional | None | $407.38 | $588.84 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $204.17 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $204.17 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $141.25 | Professional | 53 · Discontinued | $81.28 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $524.81 | Professional | 54 · Surgery only | $309.03 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $104.71 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $70.79 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $281.84 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $281.84 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $81.28 | $112.20 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $512.86 | Professional | 54 · Surgery only | $309.03 | $416.87 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $102.33 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $478.63 |
Where Texas sits
The same service costs 5.8 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
$427
AK $2,455TX $427
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.