How much rates vary
Facilitymedian $1,820 · 10th to 90th $813 to $4,571Professionalmedian $234 · 10th to 90th $39 to $437
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 $776.25 Median $3,235.94 Typical High $8,511.38 | Facility | None | $776.25 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $371.54 | Professional | None | $199.53 | $257.04 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | None | $239.88 | $239.88 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $4,897.79 | Facility | None | $1,258.93 | $2,344.23 | $4,897.79 |
BCBS Texas Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $436.52 | Professional | None | $204.17 | $269.15 | $436.52 |
Christus Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $2,691.53 | Facility | None | $691.83 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $389.05 | Professional | None | $213.80 | $281.84 | $389.05 |
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 $2,041.74 Median $2,041.74 Typical High $2,344.23 | Professional | None | $2,041.74 | $2,041.74 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $251.19 Median $1,380.38 Typical High $5,495.41 | Facility | None | $251.19 | $1,380.38 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $380.19 | Professional | None | $199.53 | $263.03 | $380.19 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $181.97 Typical High $288.40 | Professional | None | $33.11 | $181.97 | $288.40 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $1,513.56 Typical High $6,165.95 | Facility | None | $309.03 | $1,513.56 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $398.11 | Professional | None | $213.80 | $275.42 | $398.11 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $354.81 | Professional | None | $173.78 | $234.42 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $100.00 Median $123.03 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $123.03 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $50.12 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $147.91 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $138.04 | $173.78 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $125.89 Typical High $165.96 | Professional | 52 · Reduced service | $100.00 | $125.89 | $165.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $50.12 Typical High $66.07 | Professional | 53 · Discontinued | $39.81 | $50.12 | $66.07 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $186.21 Typical High $245.47 | Professional | 54 · Surgery only | $147.91 | $186.21 | $245.47 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $37.15 Typical High $48.98 | Professional | 55 · Aftercare only | $30.20 | $37.15 | $48.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $33.11 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $33.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $173.78 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $138.04 | $173.78 | $229.09 |
Where Texas sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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· 47th of 51
$257
AK $1,000KY $214
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.