How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,096 to $12,589Professionalmedian $195 · 10th to 90th $12 to $457
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $501.19 | Professional | None | $323.59 | $363.08 | $501.19 |
BCBS Texas Setting Facility Modifier None Typical Low $2,691.53 Median $9,772.37 Typical High $18,197.01 | Facility | None | $2,691.53 | $9,772.37 | $18,197.01 |
BCBS Texas Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $616.60 | Professional | None | $363.08 | $457.09 | $616.60 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,265.80 Typical High $6,025.60 | Facility | None | $691.83 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $588.84 | Professional | None | $363.08 | $446.68 | $588.84 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $2,290.87 Typical High $6,025.60 | Facility | None | $398.11 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $501.19 | Professional | None | $323.59 | $363.08 | $501.19 |
Molina Setting Professional Modifier None Typical Low $10.96 Median $63.10 Typical High $354.81 | Professional | None | $10.96 | $63.10 | $354.81 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $4,168.69 Typical High $6,606.93 | Facility | None | $562.34 | $4,168.69 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $588.84 | Professional | None | $363.08 | $446.68 | $588.84 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $602.56 | Professional | None | $302.00 | $389.05 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $162.18 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $162.18 | $177.83 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $64.57 | $70.79 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $269.15 Typical High $309.03 | Professional | 54 · Surgery only | $245.47 | $269.15 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $53.70 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $32.36 | $35.48 | $40.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $229.09 | $251.19 | $288.40 |
Where Texas sits
The same service costs 7.2 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
$224
AK $1,622TX $224
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.