How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,175 to $10,471Professionalmedian $372 · 10th to 90th $58 to $933
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 $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $2,238.72 | Professional | None | $537.03 | $588.84 | $2,238.72 |
BCBS Texas Setting Facility Modifier None Typical Low $3,981.07 Median $7,079.46 Typical High $15,848.93 | Facility | None | $3,981.07 | $7,079.46 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,148.15 | Professional | None | $537.03 | $741.31 | $1,148.15 |
Christus Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,951.21 Typical High $3,890.45 | Facility | None | $954.99 | $2,951.21 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $954.99 | Professional | None | $575.44 | $660.69 | $954.99 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,466.84 | Professional | None | $4,265.80 | $4,265.80 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $6,918.31 | Facility | None | $645.65 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $831.76 | Professional | None | $537.03 | $588.84 | $831.76 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $501.19 | Professional | None | $54.95 | $93.33 | $501.19 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,951.21 Typical High $7,585.78 | Facility | None | $812.83 | $2,951.21 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $977.24 | Professional | None | $575.44 | $660.69 | $977.24 |
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 $602.56 Typical High $912.01 | Professional | None | $457.09 | $602.56 | $912.01 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $269.15 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $295.12 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $117.49 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $446.68 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $478.63 |
Where Texas sits
The same service costs 6.9 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
$417
AK $2,754UT $398
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.