How much rates vary
Facilitymedian $2,344 · 10th to 90th $501 to $10,471Professionalmedian $513 · 10th to 90th $68 to $3,890
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 $2,818.38 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,818.38 | $3,090.30 | $3,715.35 |
BCBS Texas Setting Professional Modifier None Typical Low $2,754.23 Median $3,467.37 Typical High $5,623.41 | Professional | None | $2,754.23 | $3,467.37 | $5,623.41 |
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 $2,511.89 Median $3,715.35 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,715.35 | $5,128.61 |
Lucent Health Setting Professional Modifier None Typical Low $20,892.96 Median $20,892.96 Typical High $24,547.09 | Professional | None | $20,892.96 | $20,892.96 | $24,547.09 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,311.31 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,090.30 Typical High $3,981.07 | Professional | None | $2,818.38 | $3,090.30 | $3,981.07 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $416.87 Typical High $2,570.40 | Professional | None | $61.66 | $416.87 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,691.53 Typical High $251,188.64 | Facility | None | $812.83 | $2,691.53 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,511.89 Median $3,715.35 Typical High $5,128.61 | Professional | None | $2,511.89 | $3,715.35 | $5,128.61 |
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 $2,398.83 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,398.83 | $3,311.31 | $4,897.79 |
Wellpoint Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $1,412.54 Median $1,548.82 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,412.54 | $1,548.82 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $616.60 Typical High $707.95 | Professional | 53 · Discontinued | $575.44 | $616.60 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,344.23 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,137.96 | $2,344.23 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $467.74 Typical High $524.81 | Professional | 55 · Aftercare only | $426.58 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $309.03 Typical High $354.81 | Professional | 56 · Pre-op care only | $281.84 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,187.76 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,187.76 | $2,454.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,548.82 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,412.54 | $1,548.82 | $1,737.80 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $616.60 Typical High $691.83 | Professional | 53 · Discontinued | $575.44 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,344.23 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,137.96 | $2,344.23 | $2,570.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $467.74 Typical High $512.86 | Professional | 55 · Aftercare only | $426.58 | $467.74 | $512.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $309.03 Typical High $346.74 | Professional | 56 · Pre-op care only | $281.84 | $309.03 | $346.74 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,187.76 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,187.76 | $2,398.83 |
Where Texas sits
The same service costs 12.6 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
$955
AK $12,023TX $955
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.