How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,778 to $16,596Professionalmedian $214 · 10th to 90th $28 to $1,660
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 $1,202.26 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,202.26 | $3,801.89 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $3,311.31 | Professional | None | $1,174.90 | $1,318.26 | $3,311.31 |
BCBS Texas Setting Facility Modifier None Typical Low $6,025.60 Median $10,964.78 Typical High $25,118.86 | Facility | None | $6,025.60 | $10,964.78 | $25,118.86 |
BCBS Texas Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,659.59 | $2,511.89 |
Christus Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $5,248.07 | Facility | None | $758.58 | $3,715.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,479.11 | $2,187.76 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $10,000.00 | Professional | None | $9,332.54 | $9,332.54 | $10,000.00 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,570.40 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,318.26 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $173.78 Typical High $1,071.52 | Professional | None | $25.12 | $173.78 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $3,630.78 Typical High $5,248.07 | Facility | None | $812.83 | $3,630.78 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,479.11 | $2,238.72 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,380.38 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $588.84 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $660.69 Typical High $758.58 | Professional | 52 · Reduced service | $588.84 | $660.69 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $263.03 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $891.25 | $977.24 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $1,071.52 |
Where Texas sits
The same service costs 6.9 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
$776
AK $5,370TX $776
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.