How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,738 to $10,965Professionalmedian $224 · 10th to 90th $35 to $1,549
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 $1,202.26 Median $3,311.31 Typical High $8,709.64 | Facility | None | $1,202.26 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,288.25 | $1,621.81 |
BCBS Texas Setting Facility Modifier None Typical Low $2,187.76 Median $4,570.88 Typical High $12,882.50 | Facility | None | $2,187.76 | $4,570.88 | $12,882.50 |
BCBS Texas Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,548.82 | $2,187.76 |
Christus Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $4,677.35 Typical High $6,760.83 | Facility | None | $691.83 | $4,677.35 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,548.82 | $2,187.76 |
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 $9,549.93 Median $9,549.93 Typical High $10,232.93 | Professional | None | $9,549.93 | $9,549.93 | $10,232.93 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,398.83 Typical High $6,025.60 | Facility | None | $933.25 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,288.25 | $1,584.89 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $190.55 Typical High $1,122.02 | Professional | None | $30.90 | $190.55 | $1,122.02 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $4,677.35 Typical High $6,918.31 | Facility | None | $758.58 | $4,677.35 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,548.82 | $2,187.76 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,348.96 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $562.34 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $1,000.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $630.96 Typical High $707.95 | Professional | 52 · Reduced service | $562.34 | $630.96 | $707.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 53 · Discontinued | $223.87 | $251.19 | $281.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $851.14 | $933.25 | $1,071.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $213.80 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $213.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $141.25 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $141.25 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $1,000.00 |
Where Texas sits
The same service costs 11.0 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
$490
AK $5,370TX $490
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.