How much rates vary
Facilitymedian $10,965 · 10th to 90th $2,399 to $22,387Professionalmedian $389 · 10th to 90th $25 to $851
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 $3,715.35 Typical High $9,120.11 | Facility | None | $977.24 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,023.29 | Professional | None | $616.60 | $707.95 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $331.13 Median $630.96 Typical High $630.96 | Professional | None | $331.13 | $630.96 | $630.96 |
BCBS Texas Setting Facility Modifier None Typical Low $7,079.46 Median $12,882.50 Typical High $30,199.52 | Facility | None | $7,079.46 | $12,882.50 | $30,199.52 |
BCBS Texas Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,122.02 | Professional | None | $602.56 | $707.95 | $1,122.02 |
Christus Setting Facility Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Facility | None | $11,481.54 | $11,481.54 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $11,481.54 Typical High $16,218.10 | Facility | None | $870.96 | $11,481.54 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,202.26 | Professional | None | $691.83 | $831.76 | $1,202.26 |
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 $5,248.07 Median $5,248.07 Typical High $5,888.44 | Professional | None | $5,248.07 | $5,248.07 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $3,548.13 Typical High $10,232.93 | Facility | None | $870.96 | $3,548.13 | $10,232.93 |
Moda Health Setting Professional Modifier None Typical Low $616.60 Median $707.95 Typical High $1,023.29 | Professional | None | $616.60 | $707.95 | $1,023.29 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $602.56 | Professional | None | $21.88 | $117.49 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,454.71 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $6,760.83 Typical High $14,791.08 | Facility | None | $812.83 | $6,760.83 | $14,791.08 |
Providence Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,202.26 | Professional | None | $660.69 | $831.76 | $1,202.26 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,918.31 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,918.31 | $15,848.93 |
United Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,202.26 | Professional | None | $575.44 | $758.58 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $309.03 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $309.03 | $338.84 | $389.05 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 53 · Discontinued | $123.03 | $134.90 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $457.09 | $501.19 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $91.20 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $61.66 | $67.61 | $77.62 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $426.58 | $467.74 | $537.03 |
Where Texas sits
The same service costs 10.5 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $24,331MT $2,323
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.