How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,380 to $7,762Professionalmedian $331 · 10th to 90th $52 to $1,738
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 $1,202.26 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,202.26 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,412.54 | $1,905.46 |
BCBS Texas Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,778.28 | $2,454.71 |
Christus Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $2,570.40 Typical High $3,388.44 | Facility | None | $794.33 | $2,570.40 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,737.80 | $2,454.71 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $12,022.64 | Professional | None | $11,220.18 | $11,220.18 | $12,022.64 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,445.44 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $257.04 Typical High $1,258.93 | Professional | None | $47.86 | $257.04 | $1,258.93 |
Oscar Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $5,370.32 | Professional | None | $5,011.87 | $5,128.61 | $5,370.32 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $2,511.89 Typical High $3,388.44 | Facility | None | $933.25 | $2,511.89 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,737.80 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,584.89 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $645.65 Median $707.95 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $707.95 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $707.95 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,071.52 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $213.80 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $158.49 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $1,000.00 | $1,122.02 |
Where Texas sits
The same service costs 16.2 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
$389
AK $6,310TX $389
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.