How much rates vary
Facilitymedian $3,162 · 10th to 90th $933 to $10,471Professionalmedian $525 · 10th to 90th $81 to $1,047
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 $1,047.13 Median $3,801.89 Typical High $10,232.93 | Facility | None | $1,047.13 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $3,019.95 | Professional | None | $831.76 | $912.01 | $3,019.95 |
BCBS Texas Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,754.23 | Professional | None | $831.76 | $1,122.02 | $2,754.23 |
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 $891.25 Median $1,023.29 Typical High $1,513.56 | Professional | None | $891.25 | $1,023.29 | $1,513.56 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $831.76 Median $2,511.89 Typical High $6,918.31 | Facility | None | $831.76 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,148.15 | Professional | None | $831.76 | $912.01 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $741.31 | Professional | None | $74.13 | $138.04 | $741.31 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,479.11 Typical High $251,188.64 | Facility | None | $776.25 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,513.56 | Professional | None | $891.25 | $1,023.29 | $1,513.56 |
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 $707.95 Median $954.99 Typical High $1,445.44 | Professional | None | $707.95 | $954.99 | $1,445.44 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
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 $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $741.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $457.09 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $457.09 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $213.80 | Professional | 53 · Discontinued | $165.96 | $181.97 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $691.83 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $741.31 |
Where Texas sits
The same service costs 6.5 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
$575
AK $3,715TX $575
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.