How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,585 to $11,749Professionalmedian $794 · 10th to 90th $78 to $7,079
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 $1,000.00 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,348.96 | Professional | None | $977.24 | $1,096.48 | $1,348.96 |
BCBS Texas Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $16,218.10 | Facility | None | $4,168.69 | $7,585.78 | $16,218.10 |
Christus Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,630.78 Typical High $5,128.61 | Facility | None | $758.58 | $3,630.78 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,905.46 | Professional | None | $933.25 | $1,258.93 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $8,128.31 | Professional | None | $7,079.46 | $7,079.46 | $8,128.31 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $1,905.46 Typical High $6,025.60 | Facility | None | $912.01 | $1,905.46 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,412.54 | Professional | None | $977.24 | $1,096.48 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $588.84 Typical High $933.25 | Professional | None | $54.95 | $588.84 | $933.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $5,128.61 | Facility | None | $812.83 | $3,630.78 | $5,128.61 |
Providence Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,905.46 | Professional | None | $933.25 | $1,258.93 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,309.57 | $14,791.08 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,862.09 | Professional | None | $851.14 | $1,230.27 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
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 $489.78 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $549.54 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $549.54 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $549.54 | $616.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $194.98 | $218.78 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $812.83 | $933.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $186.21 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $97.72 | $109.65 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $758.58 | $870.96 |
Where Texas sits
The same service costs 5.1 times more in Wisconsin 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
$912
WI $4,677TX $912
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.