How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,950 to $9,550Professionalmedian $269 · 10th to 90th $41 to $1,445
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 $1,230.27 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,230.27 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,318.26 | $1,445.44 | $2,187.76 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $4,265.80 Typical High $8,912.51 | Facility | None | $2,041.74 | $4,265.80 | $8,912.51 |
BCBS Texas Setting Professional Modifier None Typical Low $1,174.90 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,513.56 | $1,995.26 |
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 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,549.93 | Professional | None | $9,549.93 | $9,549.93 | $9,549.93 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,570.40 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,570.40 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,445.44 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $199.53 Typical High $1,023.29 | Professional | None | $37.15 | $199.53 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,290.87 | Facility | None | $1,096.48 | $1,445.44 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,096.48 | $2,511.89 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $5,370.32 Typical High $11,481.54 | Facility | None | $2,290.87 | $5,370.32 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,348.96 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,096.48 | $1,122.02 | $1,122.02 |
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 $660.69 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $660.69 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $263.03 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $707.95 Typical High $891.25 | Professional | 52 · Reduced service | $660.69 | $707.95 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $354.81 | Professional | 53 · Discontinued | $263.03 | $288.40 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,318.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,230.27 |
Where Texas sits
The same service costs 8.3 times more in Wyoming 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
$708
WY $5,623UT $676
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.