How much rates vary
Facilitymedian $2,138 · 10th to 90th $871 to $6,918Professionalmedian $479 · 10th to 90th $32 to $891
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 $977.24 Median $3,311.31 Typical High $9,120.11 | Facility | None | $977.24 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $2,691.53 | Professional | None | $741.31 | $776.25 | $2,691.53 |
BCBS Texas Setting Facility Modifier None Typical Low $794.33 Median $1,479.11 Typical High $4,466.84 | Facility | None | $794.33 | $1,479.11 | $4,466.84 |
BCBS Texas Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $1,445.44 | Professional | None | $724.44 | $912.01 | $1,445.44 |
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 $776.25 Median $891.25 Typical High $1,318.26 | Professional | None | $776.25 | $891.25 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $6,025.60 | Facility | None | $707.95 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,071.52 | Professional | None | $741.31 | $758.58 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $114.82 Typical High $676.08 | Professional | None | $25.12 | $114.82 | $676.08 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $1,318.26 Typical High $251,188.64 | Facility | None | $676.08 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,318.26 | Professional | None | $776.25 | $891.25 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,288.25 | Professional | None | $602.56 | $831.76 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $371.54 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $630.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $380.19 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $151.36 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $562.34 | $676.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $134.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $630.96 |
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
$525
AK $3,090TX $525
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.