How much rates vary
Facilitymedian $2,512 · 10th to 90th $550 to $9,772Professionalmedian $316 · 10th to 90th $44 to $2,399
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 $1,905.46 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,905.46 | $2,041.74 | $2,570.40 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $8,511.38 | Facility | None | $2,041.74 | $3,630.78 | $8,511.38 |
BCBS Texas Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,862.09 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,137.96 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $14,125.38 Median $14,125.38 Typical High $14,791.08 | Professional | None | $14,125.38 | $14,125.38 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $6,025.60 | Facility | None | $1,000.00 | $2,511.89 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,041.74 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $39.81 Median $257.04 Typical High $1,584.89 | Professional | None | $39.81 | $257.04 | $1,584.89 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $1,995.26 Typical High $251,188.64 | Facility | None | $851.14 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,137.96 | $3,235.94 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,513.56 | $2,041.74 | $3,090.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $229.09 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,023.29 Typical High $1,122.02 | Professional | 52 · Reduced service | $933.25 | $1,023.29 | $1,122.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $407.38 Typical High $446.68 | Professional | 53 · Discontinued | $380.19 | $407.38 | $446.68 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $223.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,584.89 |
Where Texas sits
The same service costs 7.8 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
$1,000
AK $7,762TX $1,000
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.