How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,096 to $6,918Professionalmedian $251 · 10th to 90th $12 to $550
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $1,584.89 | Professional | None | $398.11 | $436.52 | $1,584.89 |
BCBS Texas Setting Facility Modifier None Typical Low $2,290.87 Median $4,365.16 Typical High $8,912.51 | Facility | None | $2,290.87 | $4,365.16 | $8,912.51 |
BCBS Texas Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $691.83 | Professional | None | $398.11 | $501.19 | $691.83 |
Christus Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,238.72 Typical High $2,884.03 | Facility | None | $691.83 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $724.44 | Professional | None | $436.52 | $489.78 | $724.44 |
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 $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $2,398.83 Typical High $6,025.60 | Facility | None | $457.09 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $616.60 | Professional | None | $407.38 | $436.52 | $616.60 |
Molina Setting Professional Modifier None Typical Low $11.22 Median $63.10 Typical High $354.81 | Professional | None | $11.22 | $63.10 | $354.81 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $2,238.72 Typical High $6,165.95 | Facility | None | $616.60 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $724.44 | Professional | None | $436.52 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $691.83 | Professional | None | $338.84 | $457.09 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $199.53 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $218.78 Typical High $257.04 | Professional | 52 · Reduced service | $199.53 | $218.78 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $102.33 | Professional | 53 · Discontinued | $79.43 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 54 · Surgery only | $302.00 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $77.62 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $51.29 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $309.03 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $281.84 | $309.03 | $354.81 |
Where Texas sits
The same service costs 7.1 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
$302
AK $2,042UT $288
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.