How much rates vary
Facilitymedian $1,175 · 10th to 90th $589 to $3,981Professionalmedian $398 · 10th to 90th $59 to $692
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $724.44 | Professional | None | $537.03 | $588.84 | $724.44 |
BCBS Texas Setting Professional Modifier None Typical Low $524.81 Median $707.95 Typical High $1,995.26 | Professional | None | $524.81 | $707.95 | $1,995.26 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $1,584.89 | Facility | None | $501.19 | $851.14 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $831.76 | Professional | None | $478.63 | $676.08 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,073.80 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,778.28 Typical High $6,025.60 | Facility | None | $537.03 | $1,778.28 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $724.44 | Professional | None | $537.03 | $588.84 | $724.44 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $537.03 | Professional | None | $54.95 | $97.72 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | None | $691.83 | $691.83 | $724.44 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $912.01 Typical High $3,801.89 | Facility | None | $512.86 | $912.01 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $831.76 | Professional | None | $467.74 | $691.83 | $831.76 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $831.76 | Professional | None | $436.52 | $562.34 | $831.76 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $269.15 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $269.15 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $407.38 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $117.49 | $123.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $407.38 | $436.52 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $61.66 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $61.66 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $426.58 |
Where Texas sits
The same service costs 5.5 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
$398
AK $2,188TX $398
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.