How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,413 to $12,023Professionalmedian $1,072 · 10th to 90th $30 to $1,905
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 $1,202.26 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,202.26 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,445.44 | $2,137.96 |
BCBS Texas Setting Facility Modifier None Typical Low $4,570.88 Median $8,128.31 Typical High $16,982.44 | Facility | None | $4,570.88 | $8,128.31 | $16,982.44 |
BCBS Texas Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,122.02 | $1,445.44 | $1,905.46 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $4,897.79 | Facility | None | $954.99 | $3,715.35 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,584.89 | $2,137.96 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $14,125.38 | Professional | None | $10,964.78 | $10,964.78 | $14,125.38 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,905.46 Typical High $6,760.83 | Facility | None | $1,000.00 | $1,905.46 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,479.11 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $229.09 Typical High $1,513.56 | Professional | None | $25.70 | $229.09 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $3,630.78 Typical High $7,585.78 | Facility | None | $1,023.29 | $3,630.78 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,584.89 | $2,137.96 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,318.26 Typical High $2,041.74 | Professional | None | $977.24 | $1,318.26 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $562.34 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $562.34 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $851.14 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $169.82 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $794.33 | $1,000.00 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $724.44 Typical High $812.83 | Professional | 52 · Reduced service | $562.34 | $724.44 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $288.40 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $1,202.26 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $218.78 Typical High $239.88 | Professional | 55 · Aftercare only | $169.82 | $218.78 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,023.29 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $794.33 | $1,023.29 | $1,122.02 |
Where Texas sits
The same service costs 5.2 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
$1,148
AK $6,026TX $1,148
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.