How much rates vary
Facilitymedian $3,981 · 10th to 90th $224 to $10,233Professionalmedian $437 · 10th to 90th $19 to $832
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 $467.74 Median $602.56 Typical High $707.95 | Professional | None | $467.74 | $602.56 | $707.95 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,589.25 | Facility | None | $2,398.83 | $4,897.79 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,174.90 | Professional | None | $446.68 | $660.69 | $1,174.90 |
Christus Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,467.37 Typical High $4,897.79 | Facility | None | $870.96 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $933.25 | Professional | None | $478.63 | $645.65 | $933.25 |
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 $4,466.84 Median $4,466.84 Typical High $5,370.32 | Professional | None | $4,466.84 | $4,466.84 | $5,370.32 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $1,513.56 Typical High $6,025.60 | Facility | None | $524.81 | $1,513.56 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $724.44 | Professional | None | $467.74 | $602.56 | $724.44 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $97.72 Typical High $588.84 | Professional | None | $14.79 | $97.72 | $588.84 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $3,388.44 Typical High $6,760.83 | Facility | None | $660.69 | $3,388.44 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $933.25 | Professional | None | $478.63 | $645.65 | $933.25 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $891.25 | Professional | None | $398.11 | $588.84 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $234.42 Median $288.40 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $346.74 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $87.10 Typical High $104.71 | Professional | 55 · Aftercare only | $69.18 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $323.59 | $398.11 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $281.84 Typical High $354.81 | Professional | 52 · Reduced service | $234.42 | $281.84 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $114.82 Typical High $141.25 | Professional | 53 · Discontinued | $93.33 | $114.82 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $346.74 | $426.58 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $57.54 Typical High $70.79 | Professional | 56 · Pre-op care only | $46.77 | $57.54 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $323.59 | $398.11 | $489.78 |
Where Texas sits
The same service costs 5.0 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
$479
AK $2,344UT $468
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.