How much rates vary
Facilitymedian $2,291 · 10th to 90th $692 to $8,710Professionalmedian $355 · 10th to 90th $55 to $661
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 $1,000.00 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $2,137.96 | Professional | None | $501.19 | $562.34 | $2,137.96 |
BCBS Texas Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $3,467.37 | Facility | None | $562.34 | $1,023.29 | $3,467.37 |
BCBS Texas Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $891.25 | Professional | None | $501.19 | $645.65 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $912.01 | Professional | None | $549.54 | $616.60 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Professional | None | $8,317.64 | $8,317.64 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $2,511.89 Typical High $6,918.31 | Facility | None | $562.34 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $758.58 | Professional | None | $512.86 | $562.34 | $758.58 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $89.13 Typical High $478.63 | Professional | None | $52.48 | $89.13 | $478.63 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $1,318.26 Typical High $251,188.64 | Facility | None | $602.56 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $912.01 | Professional | None | $549.54 | $616.60 | $912.01 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $870.96 | Professional | None | $426.58 | $562.34 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $251.19 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | 52 · Reduced service | $251.19 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $128.82 | Professional | 53 · Discontinued | $100.00 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $64.57 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Where Texas sits
The same service costs 6.0 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
$389
AK $2,239UT $372
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.