How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,549 to $16,596Professionalmedian $316 · 10th to 90th $52 to $1,698
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 $1,348.96 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,479.11 | $1,737.80 |
BCBS Texas Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,479.11 | $1,862.09 | $2,511.89 |
Christus Setting Facility Modifier None Typical Low $11,220.18 Median $11,220.18 Typical High $11,220.18 | Facility | None | $11,220.18 | $11,220.18 | $11,220.18 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $10,715.19 Typical High $15,135.61 | Facility | None | $794.33 | $10,715.19 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,819.70 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Professional | None | $15,135.61 | $15,135.61 | $15,135.61 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,344.23 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,513.56 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $257.04 Typical High $1,348.96 | Professional | None | $47.86 | $257.04 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $10,232.93 Typical High $14,791.08 | Facility | None | $933.25 | $10,232.93 | $14,791.08 |
Providence Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,819.70 | $2,570.40 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $9,772.37 Typical High $21,379.62 | Facility | None | $3,981.07 | $9,772.37 | $21,379.62 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,621.81 | $2,511.89 |
Wellpoint Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $676.08 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $346.74 | Professional | 53 · Discontinued | $269.15 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $741.31 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $295.12 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,174.90 |
Where Texas sits
The same service costs 20.4 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
$324
AK $6,607TX $324
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.