How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,000 to $8,128Professionalmedian $347 · 10th to 90th $36 to $550
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $537.03 | Professional | None | $323.59 | $446.68 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $10,232.93 | Facility | None | $2,290.87 | $4,365.16 | $10,232.93 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $426.58 Typical High $660.69 | Professional | None | $309.03 | $426.58 | $660.69 |
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 $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $630.96 | Professional | None | $331.13 | $457.09 | $630.96 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,073.80 | Professional | None | $3,235.94 | $3,235.94 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $416.87 Median $1,174.90 Typical High $4,786.30 | Facility | None | $416.87 | $1,174.90 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $537.03 | Professional | None | $323.59 | $446.68 | $537.03 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $275.42 Typical High $457.09 | Professional | None | $32.36 | $275.42 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $426.58 | Professional | None | $407.38 | $407.38 | $426.58 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $3,162.28 Typical High $4,786.30 | Facility | None | $467.74 | $3,162.28 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $630.96 | Professional | None | $331.13 | $457.09 | $630.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $616.60 | Professional | None | $281.84 | $407.38 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $162.18 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $223.87 Typical High $257.04 | Professional | 52 · Reduced service | $162.18 | $223.87 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $64.57 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $245.47 | $338.84 | $389.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $48.98 | $67.61 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $44.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $32.36 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $316.23 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $229.09 | $316.23 | $363.08 |
Where Texas sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 49th of 51
$355
AK $1,318NJ $331
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.