How much rates vary
Facilitymedian $3,311 · 10th to 90th $977 to $10,000Professionalmedian $389 · 10th to 90th $63 to $1,905
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,659.59 | $1,949.84 |
BCBS Texas Setting Facility Modifier None Typical Low $1,479.11 Median $5,011.87 Typical High $20,892.96 | Facility | None | $1,479.11 | $5,011.87 | $20,892.96 |
BCBS Texas Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,089.30 | $2,818.38 |
Christus Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,148.15 Typical High $2,290.87 | Facility | None | $776.25 | $1,148.15 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,041.74 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $19,054.61 Typical High $19,054.61 | Professional | None | $19,054.61 | $19,054.61 | $19,054.61 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,630.27 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,630.27 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,659.59 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $309.03 Typical High $1,513.56 | Professional | None | $57.54 | $309.03 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,202.26 Typical High $2,691.53 | Facility | None | $812.83 | $1,202.26 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,659.59 | $2,041.74 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,412.54 | $1,905.46 | $3,019.95 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $758.58 Median $831.76 Typical High $977.24 | Professional | 52 · Reduced service | $758.58 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $389.05 | Professional | 53 · Discontinued | $302.00 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $288.40 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,348.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $831.76 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,258.93 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,174.90 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,174.90 | $1,318.26 |
Where Texas sits
The same service costs 18.6 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
$398
AK $7,413TX $398
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.