How much rates vary
Facilitymedian $2,884 · 10th to 90th $363 to $7,762Professionalmedian $912 · 10th to 90th $132 to $3,020
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 $977.24 Median $3,235.94 Typical High $8,511.38 | Facility | None | $977.24 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,318.26 Typical High $1,698.24 | Professional | None | $380.19 | $1,318.26 | $1,698.24 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $10,000.00 | Facility | None | $2,630.27 | $4,786.30 | $10,000.00 |
BCBS Texas Setting Professional Modifier None Typical Low $363.08 Median $1,023.29 Typical High $1,819.70 | Professional | None | $363.08 | $1,023.29 | $1,819.70 |
Christus Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,089.30 Typical High $2,884.03 | Facility | None | $724.44 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,778.28 | Professional | None | $416.87 | $776.25 | $1,778.28 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $11,748.98 | Professional | None | $8,317.64 | $8,317.64 | $11,748.98 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $1,995.26 Typical High $6,918.31 | Facility | None | $426.58 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $380.19 Median $1,258.93 Typical High $1,698.24 | Professional | None | $380.19 | $1,258.93 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $239.88 Typical High $1,288.25 | Professional | None | $97.72 | $239.88 | $1,288.25 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $1,230.27 Typical High $2,884.03 | Professional | None | $407.38 | $1,230.27 | $2,884.03 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,089.30 Typical High $6,165.95 | Facility | None | $630.96 | $2,089.30 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $1,778.28 | Professional | None | $416.87 | $776.25 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,332.54 | Facility | None | $1,698.24 | $4,570.88 | $9,332.54 |
United Setting Professional Modifier None Typical Low $323.59 Median $1,000.00 Typical High $1,862.09 | Professional | None | $323.59 | $1,000.00 | $1,862.09 |
Wellpoint Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $190.55 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $190.55 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $75.86 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $933.25 Typical High $1,122.02 | Professional | 54 · Surgery only | $281.84 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $186.21 Typical High $223.87 | Professional | 55 · Aftercare only | $56.23 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $38.02 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $870.96 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $263.03 | $870.96 | $1,047.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $190.55 | $630.96 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $75.86 | $251.19 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $281.84 | $954.99 | $1,122.02 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $56.23 | $190.55 | $223.87 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $38.02 | $125.89 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $263.03 | $891.25 | $1,047.13 |
Where Texas sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 47th of 51
$1,072
AK $3,020NE $692
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.