How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,230 to $8,128Professionalmedian $1,047 · 10th to 90th $123 to $10,233
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 $331.13 Median $1,548.82 Typical High $1,995.26 | Professional | None | $331.13 | $1,548.82 | $1,995.26 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $5,011.87 Typical High $9,772.37 | Facility | None | $2,630.27 | $5,011.87 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $316.23 Median $1,202.26 Typical High $2,137.96 | Professional | None | $316.23 | $1,202.26 | $2,137.96 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,089.30 Typical High $2,754.23 | Facility | None | $724.44 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $707.95 Typical High $1,995.26 | Professional | None | $363.08 | $707.95 | $1,995.26 |
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 $10,232.93 Median $10,232.93 Typical High $13,803.84 | Professional | None | $10,232.93 | $10,232.93 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $1,995.26 Typical High $5,495.41 | Facility | None | $416.87 | $1,995.26 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $1,513.56 Typical High $1,995.26 | Professional | None | $331.13 | $1,513.56 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $275.42 Typical High $1,513.56 | Professional | None | $95.50 | $275.42 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $2,089.30 Typical High $6,165.95 | Facility | None | $616.60 | $2,089.30 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $758.58 Typical High $1,995.26 | Professional | None | $363.08 | $758.58 | $1,995.26 |
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 $275.42 Median $891.25 Typical High $1,905.46 | Professional | None | $275.42 | $891.25 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $165.96 Median $645.65 Typical High $870.96 | Professional | 52 · Reduced service | $165.96 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $257.04 Typical High $354.81 | Professional | 53 · Discontinued | $66.07 | $257.04 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $954.99 Typical High $1,318.26 | Professional | 54 · Surgery only | $245.47 | $954.99 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $194.98 Typical High $263.03 | Professional | 55 · Aftercare only | $48.98 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $128.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $33.11 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $891.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $229.09 | $891.25 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $660.69 Typical High $870.96 | Professional | 52 · Reduced service | $165.96 | $660.69 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $263.03 Typical High $354.81 | Professional | 53 · Discontinued | $66.07 | $263.03 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $1,000.00 Typical High $1,318.26 | Professional | 54 · Surgery only | $245.47 | $1,000.00 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $199.53 Typical High $263.03 | Professional | 55 · Aftercare only | $48.98 | $199.53 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $131.83 Typical High $173.78 | Professional | 56 · Pre-op care only | $33.11 | $131.83 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $933.25 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $229.09 | $933.25 | $1,230.27 |
Where Texas sits
The same service costs 5.8 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· 45th of 51
$1,230
AK $3,548NE $617
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.