How much rates vary
Facilitymedian $2,399 · 10th to 90th $955 to $5,888Professionalmedian $309 · 10th to 90th $50 to $537
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $588.84 | Professional | None | $398.11 | $446.68 | $588.84 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $6,456.54 | Facility | None | $1,659.59 | $2,951.21 | $6,456.54 |
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 $602.56 Median $1,202.26 Typical High $2,187.76 | Facility | None | $602.56 | $1,202.26 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $724.44 | Professional | None | $436.52 | $537.03 | $724.44 |
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 $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,905.46 Typical High $5,495.41 | Facility | None | $467.74 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $446.68 Typical High $575.44 | Professional | None | $398.11 | $446.68 | $575.44 |
Molina Setting Professional Modifier None Typical Low $12.59 Median $75.86 Typical High $436.52 | Professional | None | $12.59 | $75.86 | $436.52 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $1,318.26 Typical High $4,466.84 | Facility | None | $562.34 | $1,318.26 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $436.52 Median $537.03 Typical High $724.44 | Professional | None | $436.52 | $537.03 | $724.44 |
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 $363.08 Median $467.74 Typical High $676.08 | Professional | None | $363.08 | $467.74 | $676.08 |
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 $199.53 Median $218.78 Typical High $251.19 | Professional | 52 · Reduced service | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $50.12 |
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 $251.19 | Professional | 52 · Reduced service | $199.53 | $218.78 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $89.13 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $331.13 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $75.86 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $44.67 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $44.67 | $50.12 |
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 5.8 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
$331
AK $1,862UT $324
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.