How much rates vary
Facilitymedian $1,995 · 10th to 90th $933 to $6,607Professionalmedian $741 · 10th to 90th $107 to $1,288
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 $2,754.23 Typical High $6,918.31 | Facility | None | $977.24 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $891.25 | $1,000.00 | $1,230.27 |
BCBS Texas Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,380.38 | $1,905.46 |
Christus Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,818.38 | Facility | None | $831.76 | $1,230.27 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,621.81 | Professional | None | $954.99 | $1,258.93 | $1,621.81 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $9,772.37 | Professional | None | $7,585.78 | $7,585.78 | $9,772.37 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $5,495.41 | Facility | None | $707.95 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $891.25 | $1,023.29 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $1,071.52 | Professional | None | $102.33 | $199.53 | $1,071.52 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $1,412.54 Typical High $6,760.83 | Facility | None | $870.96 | $1,412.54 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,621.81 | Professional | None | $954.99 | $1,258.93 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,513.56 | Professional | None | $741.31 | $977.24 | $1,513.56 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $446.68 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $501.19 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $501.19 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $181.97 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $758.58 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $794.33 |
Where Texas sits
The same service costs 5.9 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
$759
AK $4,467TX $759
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.