How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $9,772Professionalmedian $631 · 10th to 90th $63 to $1,000
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 $891.25 Median $3,630.78 Typical High $8,709.64 | Facility | None | $891.25 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,000.00 | Professional | None | $645.65 | $831.76 | $1,000.00 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,302.69 | Facility | None | $2,398.83 | $4,897.79 | $12,302.69 |
BCBS Texas Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,479.11 | Professional | None | $616.60 | $831.76 | $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 $870.96 Median $3,467.37 Typical High $4,897.79 | Facility | None | $870.96 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,148.15 | Professional | None | $676.08 | $891.25 | $1,148.15 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $7,413.10 | Professional | None | $6,165.95 | $6,165.95 | $7,413.10 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,513.56 Typical High $6,025.60 | Facility | None | $691.83 | $1,513.56 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $977.24 | Professional | None | $645.65 | $831.76 | $977.24 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $812.83 | Professional | None | $56.23 | $151.36 | $812.83 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $794.33 | Professional | None | $758.58 | $758.58 | $794.33 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $3,388.44 Typical High $6,760.83 | Facility | None | $812.83 | $3,388.44 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,122.02 | Professional | None | $676.08 | $891.25 | $1,122.02 |
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 $549.54 Median $758.58 Typical High $1,122.02 | Professional | None | $549.54 | $758.58 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $323.59 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $323.59 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $128.82 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $724.44 | Professional | 54 · Surgery only | $489.78 | $630.96 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $125.89 Typical High $144.54 | Professional | 55 · Aftercare only | $97.72 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $416.87 Typical High $478.63 | Professional | 52 · Reduced service | $323.59 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $165.96 Typical High $190.55 | Professional | 53 · Discontinued | $128.82 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $489.78 | $630.96 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $97.72 | $125.89 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $95.50 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $660.69 |
Where Texas sits
The same service costs 4.4 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
$646
AK $2,754NJ $631
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.