How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,622 to $9,772Professionalmedian $437 · 10th to 90th $63 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 $1,412.54 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,621.81 | $2,041.74 |
BCBS Texas Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,621.81 | $2,089.30 | $2,818.38 |
Christus Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,265.80 Typical High $6,025.60 | Facility | None | $758.58 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,584.89 | $1,995.26 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,848.93 | Professional | None | $15,135.61 | $15,135.61 | $15,848.93 |
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 $1,412.54 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,621.81 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $316.23 Typical High $1,659.59 | Professional | None | $58.88 | $316.23 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $4,168.69 Typical High $6,025.60 | Facility | None | $870.96 | $4,168.69 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,995.26 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,309.57 | $15,135.61 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,621.81 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $707.95 Median $794.33 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $275.42 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,288.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $794.33 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $323.59 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,258.93 |
Where Texas sits
The same service costs 11.2 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
$646
AK $7,244TX $646
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.