How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,380 to $12,303Professionalmedian $661 · 10th to 90th $23 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 $1,202.26 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,202.26 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,288.25 | $3,019.95 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $8,511.38 Typical High $16,595.87 | Facility | None | $4,365.16 | $8,511.38 | $16,595.87 |
BCBS Texas Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,412.54 | $2,041.74 |
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 $758.58 Median $3,467.37 Typical High $4,897.79 | Facility | None | $758.58 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,348.96 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $9,332.54 | Professional | None | $8,709.64 | $8,709.64 | $9,332.54 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $2,454.71 Typical High $6,760.83 | Facility | None | $977.24 | $2,454.71 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,288.25 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $154.88 Typical High $1,000.00 | Professional | None | $20.42 | $154.88 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $3,388.44 Typical High $4,897.79 | Facility | None | $794.33 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,348.96 | $1,737.80 |
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 $851.14 Median $1,174.90 Typical High $1,778.28 | Professional | None | $851.14 | $1,174.90 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $575.44 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $645.65 Typical High $691.83 | Professional | 52 · Reduced service | $575.44 | $645.65 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $257.04 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,047.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $208.93 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $977.24 |
Where Texas sits
The same service costs 6.5 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
$759
AK $4,898TX $759
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.