How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,622 to $8,128Professionalmedian $417 · 10th to 90th $60 to $741
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 $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $933.25 | Professional | None | $588.84 | $630.96 | $933.25 |
BCBS Texas Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,235.94 | $8,317.64 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,000.00 | Professional | None | $562.34 | $724.44 | $1,000.00 |
Christus Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,187.76 Typical High $3,311.31 | Facility | None | $870.96 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $891.25 | Professional | None | $512.86 | $741.31 | $891.25 |
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 $5,128.61 Median $5,128.61 Typical High $5,248.07 | Professional | None | $5,128.61 | $5,128.61 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $6,760.83 | Facility | None | $630.96 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $794.33 | Professional | None | $588.84 | $630.96 | $794.33 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $109.65 Typical High $562.34 | Professional | None | $54.95 | $109.65 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $660.69 Median $1,174.90 Typical High $1,479.11 | Professional | None | $660.69 | $1,174.90 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $6,760.83 | Facility | None | $794.33 | $2,238.72 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $758.58 Typical High $891.25 | Professional | None | $512.86 | $758.58 | $891.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $912.01 | Professional | None | $478.63 | $630.96 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $295.12 Median $316.23 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $549.54 | Professional | 54 · Surgery only | $436.52 | $478.63 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $109.65 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $72.44 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $295.12 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $316.23 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $125.89 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $478.63 Typical High $501.19 | Professional | 54 · Surgery only | $436.52 | $478.63 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $446.68 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $407.38 | $446.68 | $467.74 |
Where Texas sits
The same service costs 5.9 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
$427
AK $2,512TX $427
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.