How much rates vary
Facilitymedian $1,622 · 10th to 90th $603 to $8,710Professionalmedian $151 · 10th to 90th $17 to $1,072
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 $912.01 Median $3,715.35 Typical High $9,120.11 | Facility | None | $912.01 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,047.13 | Professional | None | $776.25 | $831.76 | $1,047.13 |
BCBS Texas Setting Facility Modifier None Typical Low $851.14 Median $1,584.89 Typical High $8,511.38 | Facility | None | $851.14 | $1,584.89 | $8,511.38 |
BCBS Texas Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,584.89 | Professional | None | $741.31 | $933.25 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,412.54 | Professional | None | $794.33 | $912.01 | $1,412.54 |
Lucent Health Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $6,918.31 | Professional | None | $5,754.40 | $5,754.40 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $1,819.70 Typical High $6,918.31 | Facility | None | $776.25 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,096.48 | Professional | None | $776.25 | $831.76 | $1,096.48 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $112.20 Typical High $724.44 | Professional | None | $15.14 | $112.20 | $724.44 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,380.38 Typical High $251,188.64 | Facility | None | $776.25 | $1,380.38 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,412.54 | Professional | None | $794.33 | $912.01 | $1,412.54 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,318.26 | Professional | None | $645.65 | $870.96 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $389.05 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $416.87 | $457.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $169.82 | $186.21 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $630.96 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $630.96 | $691.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $138.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $93.33 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $588.84 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $588.84 | $645.65 |
Where Texas sits
The same service costs 6.2 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
$537
AK $3,311TX $537
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.