How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,622 to $9,772Professionalmedian $437 · 10th to 90th $69 to $2,239
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 $1,905.46 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,905.46 | $2,398.83 |
BCBS Texas Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,344.23 | $3,162.28 |
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 $794.33 Median $4,265.80 Typical High $6,025.60 | Facility | None | $794.33 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,290.87 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $15,848.93 | Professional | None | $14,791.08 | $14,791.08 | $15,848.93 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,754.23 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,905.46 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $331.13 Typical High $1,659.59 | Professional | None | $63.10 | $331.13 | $1,659.59 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $4,168.69 Typical High $6,025.60 | Facility | None | $933.25 | $4,168.69 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,737.80 | $2,290.87 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,165.95 | $15,135.61 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,949.84 | $2,884.03 |
Wellpoint Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $933.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $851.14 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | 53 · Discontinued | $338.84 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,513.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $933.25 Typical High $1,071.52 | Professional | 52 · Reduced service | $851.14 | $933.25 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | 53 · Discontinued | $338.84 | $380.19 | $426.58 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $316.23 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $213.80 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $213.80 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,479.11 |
Where Texas sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $18,090KY $3,723
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.