How much rates vary
Facilitymedian $2,138 · 10th to 90th $513 to $10,471Professionalmedian $158 · 10th to 90th $17 to $1,202
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 $1,023.29 Median $3,801.89 Typical High $10,232.93 | Facility | None | $1,023.29 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $3,019.95 | Professional | None | $912.01 | $954.99 | $3,019.95 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
BCBS Texas Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,584.89 | Professional | None | $724.44 | $1,000.00 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,659.59 | Professional | None | $954.99 | $1,096.48 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $7,244.36 | Professional | None | $6,918.31 | $6,918.31 | $7,244.36 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $2,511.89 Typical High $6,918.31 | Facility | None | $870.96 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $1,258.93 | Professional | None | $912.01 | $933.25 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $123.03 Typical High $812.83 | Professional | None | $15.14 | $123.03 | $812.83 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $251,188.64 | Facility | None | $812.83 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,096.48 Typical High $1,659.59 | Professional | None | $954.99 | $1,096.48 | $1,659.59 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,621.81 | Professional | None | $741.31 | $1,023.29 | $1,621.81 |
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 $457.09 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $776.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $467.74 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $186.21 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $691.83 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $93.33 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $776.25 |
Where Texas sits
The same service costs 6.6 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
$575
AK $3,802TX $575
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.