How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,089 to $10,233Professionalmedian $282 · 10th to 90th $39 to $1,995
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 $10,232.93 | Facility | None | $1,230.27 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,698.24 | $1,778.28 | $3,467.37 |
BCBS Texas Setting Facility Modifier None Typical Low $2,951.21 Median $5,370.32 Typical High $11,220.18 | Facility | None | $2,951.21 | $5,370.32 | $11,220.18 |
BCBS Texas Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,819.70 | $2,398.83 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $4,897.79 | Facility | None | $758.58 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,089.30 | $3,162.28 |
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 $14,791.08 Median $14,791.08 Typical High $14,791.08 | Professional | None | $14,791.08 | $14,791.08 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,818.38 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,778.28 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $239.88 Typical High $1,479.11 | Professional | None | $35.48 | $239.88 | $1,479.11 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $3,388.44 Typical High $4,897.79 | Facility | None | $758.58 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,089.30 | $3,162.28 |
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 $1,445.44 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,949.84 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $851.14 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $407.38 | Professional | 53 · Discontinued | $338.84 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $891.25 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $407.38 | Professional | 53 · Discontinued | $338.84 | $354.81 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,318.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,318.26 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $204.17 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,230.27 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,230.27 | $1,445.44 |
Where Texas sits
The same service costs 6.9 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
$1,096
AK $7,586TX $1,096
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.