How much rates vary
Facilitymedian $2,399 · 10th to 90th $562 to $10,471Professionalmedian $275 · 10th to 90th $34 to $2,042
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,445.44 | $1,737.80 |
BCBS Texas Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $15,848.93 | Facility | None | $1,698.24 | $3,162.28 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,230.27 | $1,698.24 | $3,311.31 |
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 $1,584.89 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,862.09 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $13,803.84 | Professional | None | $10,964.78 | $10,964.78 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,187.76 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,445.44 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $218.78 Typical High $1,412.54 | Professional | None | $31.62 | $218.78 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,819.70 Typical High $251,188.64 | Facility | None | $812.83 | $1,819.70 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,862.09 | $2,630.27 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,659.59 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $645.65 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $707.95 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,148.15 |
Where Texas sits
The same service costs 7.2 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
$891
AK $6,457TX $891
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.