How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,820 to $11,482Professionalmedian $479 · 10th to 90th $60 to $794
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 $1,000.00 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,000.00 | Professional | None | $724.44 | $776.25 | $1,000.00 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,589.25 | Facility | None | $2,398.83 | $4,897.79 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,479.11 | Professional | None | $676.08 | $851.14 | $1,479.11 |
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 $602.56 Median $831.76 Typical High $1,096.48 | Professional | None | $602.56 | $831.76 | $1,096.48 |
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 $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $2,511.89 Typical High $6,918.31 | Facility | None | $741.31 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $933.25 | Professional | None | $724.44 | $776.25 | $933.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $125.89 Typical High $676.08 | Professional | None | $56.23 | $125.89 | $676.08 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $3,715.35 Typical High $7,585.78 | Facility | None | $891.25 | $3,715.35 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,071.52 | Professional | None | $602.56 | $831.76 | $1,071.52 |
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 $562.34 Median $758.58 Typical High $1,096.48 | Professional | None | $562.34 | $758.58 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $363.08 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $363.08 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $144.54 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $537.03 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $380.19 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $380.19 | $416.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $144.54 | $154.88 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $537.03 | $575.44 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $77.62 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $575.44 |
Where Texas sits
The same service costs 6.2 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
$490
AK $3,020TX $490
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.