How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,202 to $6,918Professionalmedian $331 · 10th to 90th $52 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 $933.25 Median $3,801.89 Typical High $9,120.11 | Facility | None | $933.25 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $537.03 | Professional | None | $302.00 | $371.54 | $537.03 |
BCBS Texas Setting Facility Modifier None Typical Low $1,348.96 Median $2,630.27 Typical High $6,918.31 | Facility | None | $1,348.96 | $2,630.27 | $6,918.31 |
BCBS Texas Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $831.76 | Professional | None | $354.81 | $489.78 | $831.76 |
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 $954.99 Median $2,238.72 Typical High $3,801.89 | Facility | None | $954.99 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $616.60 | Professional | None | $354.81 | $416.87 | $616.60 |
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 $3,019.95 Median $3,019.95 Typical High $3,715.35 | Professional | None | $3,019.95 | $3,019.95 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,737.80 Typical High $6,918.31 | Facility | None | $371.54 | $1,737.80 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $602.56 | Professional | None | $302.00 | $371.54 | $602.56 |
Molina Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $426.58 | Professional | None | $45.71 | $83.18 | $426.58 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $2,290.87 Typical High $7,585.78 | Facility | None | $446.68 | $2,290.87 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $616.60 | Professional | None | $354.81 | $416.87 | $616.60 |
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 $302.00 Median $407.38 Typical High $588.84 | Professional | None | $302.00 | $407.38 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $147.91 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $147.91 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $58.88 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $218.78 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $302.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $147.91 | $173.78 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $70.79 Typical High $87.10 | Professional | 53 · Discontinued | $58.88 | $70.79 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $218.78 | $263.03 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $52.48 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $52.48 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $35.48 Typical High $43.65 | Professional | 56 · Pre-op care only | $29.51 | $35.48 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $204.17 | $245.47 | $302.00 |
Where Texas sits
The same service costs 3.8 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
$363
AK $1,349UT $355
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.