How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,202 to $10,471Professionalmedian $525 · 10th to 90th $34 to $977
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 $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $2,754.23 | Professional | None | $812.83 | $851.14 | $2,754.23 |
BCBS Texas Setting Facility Modifier None Typical Low $3,890.45 Median $7,079.46 Typical High $14,791.08 | Facility | None | $3,890.45 | $7,079.46 | $14,791.08 |
BCBS Texas Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $954.99 | Professional | None | $741.31 | $812.83 | $954.99 |
Christus Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $4,466.84 | Facility | None | $691.83 | $3,162.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,445.44 | Professional | None | $851.14 | $977.24 | $1,445.44 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Professional | None | $8,128.31 | $8,128.31 | $8,128.31 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,398.83 Typical High $6,025.60 | Facility | None | $758.58 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $1,148.15 | Professional | None | $812.83 | $831.76 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $125.89 Typical High $741.31 | Professional | None | $27.54 | $125.89 | $741.31 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $3,235.94 Typical High $6,606.93 | Facility | None | $741.31 | $3,235.94 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,445.44 | Professional | None | $851.14 | $977.24 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,000.00 | Facility | None | $1,698.24 | $4,570.88 | $10,000.00 |
United Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,412.54 | Professional | None | $660.69 | $891.25 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $407.38 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $416.87 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $616.60 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $691.83 |
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
$589
AK $3,467TX $589
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.