How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,122 to $8,318Professionalmedian $468 · 10th to 90th $71 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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $3,801.89 | Professional | None | $562.34 | $630.96 | $3,801.89 |
BCBS Texas Setting Facility Modifier None Typical Low $2,754.23 Median $5,011.87 Typical High $9,772.37 | Facility | None | $2,754.23 | $5,011.87 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $912.01 | Professional | None | $524.81 | $660.69 | $912.01 |
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 $691.83 Median $2,089.30 Typical High $2,754.23 | Facility | None | $691.83 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,071.52 | Professional | None | $588.84 | $691.83 | $1,071.52 |
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 $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $6,025.60 | Facility | None | $645.65 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $954.99 | Professional | None | $562.34 | $630.96 | $954.99 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $371.54 Typical High $562.34 | Professional | None | $64.57 | $371.54 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | None | $1,905.46 | $1,905.46 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $2,089.30 Typical High $6,165.95 | Facility | None | $660.69 | $2,089.30 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,071.52 | Professional | None | $588.84 | $691.83 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,047.13 | Professional | None | $489.78 | $691.83 | $1,047.13 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $281.84 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $112.20 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $107.15 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $309.03 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $125.89 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $467.74 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $467.74 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $93.33 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $93.33 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $63.10 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $63.10 | $70.79 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $436.52 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $436.52 | $489.78 |
Where Texas sits
The same service costs 5.9 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
$550
AK $3,236TX $550
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.