How much rates vary
Facilitymedian $2,138 · 10th to 90th $501 to $10,471Professionalmedian $316 · 10th to 90th $43 to $2,630
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 $2,041.74 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,238.72 | $2,754.23 |
BCBS Texas Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,041.74 | $2,630.27 |
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 $2,041.74 Median $2,344.23 Typical High $3,467.37 | Professional | None | $2,041.74 | $2,344.23 | $3,467.37 |
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 $2,630.27 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,630.27 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,238.72 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $263.03 Typical High $1,698.24 | Professional | None | $38.90 | $263.03 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $251,188.64 | Facility | None | $812.83 | $2,137.96 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $3,467.37 | Professional | None | $2,041.74 | $2,344.23 | $3,467.37 |
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 $1,659.59 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,238.72 | $3,388.44 |
Wellpoint Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $1,023.29 Median $1,122.02 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $407.38 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $223.87 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,737.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,122.02 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,202.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | 53 · Discontinued | $407.38 | $446.68 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,819.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $363.08 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $363.08 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $223.87 Typical High $245.47 | Professional | 56 · Pre-op care only | $204.17 | $223.87 | $245.47 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,698.24 |
Where Texas sits
The same service costs 22.9 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
$372
AK $8,511TX $372
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.