How much rates vary
Facilitymedian $2,818 · 10th to 90th $912 to $9,333Professionalmedian $437 · 10th to 90th $69 to $708
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 $562.34 Median $575.44 Typical High $776.25 | Professional | None | $562.34 | $575.44 | $776.25 |
BCBS Texas Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $676.08 | Professional | None | $512.86 | $562.34 | $676.08 |
Christus Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,398.83 | Facility | None | $758.58 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,023.29 | Professional | None | $602.56 | $676.08 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $10,964.78 | Professional | None | $10,964.78 | $10,964.78 | $10,964.78 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $6,918.31 | Facility | None | $562.34 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $776.25 | Professional | None | $562.34 | $575.44 | $776.25 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $380.19 Typical High $549.54 | Professional | None | $64.57 | $380.19 | $549.54 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $1,258.93 Typical High $2,454.71 | Facility | None | $616.60 | $1,258.93 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,023.29 | Professional | None | $602.56 | $676.08 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $977.24 | Professional | None | $457.09 | $616.60 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $281.84 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $288.40 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $112.20 | $114.82 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $436.52 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $87.10 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $407.38 | $478.63 |
Where Texas sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 50th of 51
$457
AK $2,344UT $447
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.