How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,259 to $9,333Professionalmedian $224 · 10th to 90th $34 to $1,479
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 $1,202.26 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,380.38 | $1,698.24 |
BCBS Texas Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,698.24 | $3,890.45 |
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 $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,659.59 | $2,398.83 |
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 $11,220.18 Median $11,220.18 Typical High $11,220.18 | Professional | None | $11,220.18 | $11,220.18 | $11,220.18 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $6,025.60 | Facility | None | $933.25 | $2,511.89 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,202.26 | $1,380.38 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $199.53 Typical High $1,230.27 | Professional | None | $31.62 | $199.53 | $1,230.27 |
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 $1,348.96 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,659.59 | $2,398.83 |
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 $1,122.02 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,479.11 | $2,137.96 |
Wellpoint Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $602.56 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $1,071.52 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $602.56 | $676.08 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $239.88 | $269.15 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | 54 · Surgery only | $912.01 | $1,000.00 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 55 · Aftercare only | $181.97 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $120.23 | $134.90 | $151.36 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $851.14 | $933.25 | $1,071.52 |
Where Texas sits
The same service costs 24.5 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
$234
AK $5,754TX $234
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.