How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,622 to $12,882Professionalmedian $219 · 10th to 90th $28 to $1,585
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 $1,230.27 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,230.27 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $3,019.95 | Professional | None | $1,258.93 | $1,380.38 | $3,019.95 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $17,378.01 | Facility | None | $4,365.16 | $7,943.28 | $17,378.01 |
BCBS Texas Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,258.93 | $1,621.81 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $4,897.79 | Facility | None | $954.99 | $3,715.35 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,445.44 | $2,041.74 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $10,000.00 | Professional | None | $9,332.54 | $9,332.54 | $10,000.00 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,380.38 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $169.82 Typical High $1,071.52 | Professional | None | $25.12 | $169.82 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $7,585.78 | Facility | None | $1,000.00 | $3,715.35 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,445.44 | $2,041.74 |
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 $977.24 Median $1,318.26 Typical High $1,995.26 | Professional | None | $977.24 | $1,318.26 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $630.96 Median $691.83 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $691.83 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $275.42 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $1,047.13 |
Where Texas sits
The same service costs 6.6 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
$794
AK $5,248TX $794
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.