How much rates vary
Facilitymedian $2,630 · 10th to 90th $447 to $8,511Professionalmedian $776 · 10th to 90th $100 to $6,026
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 $3,890.45 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,890.45 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,897.79 Typical High $6,165.95 | Professional | None | $4,466.84 | $4,897.79 | $6,165.95 |
BCBS Texas Setting Professional Modifier None Typical Low $4,365.16 Median $5,495.41 Typical High $8,912.51 | Professional | None | $4,365.16 | $5,495.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $10,715.19 | Professional | None | $8,709.64 | $8,709.64 | $10,715.19 |
Lucent Health Setting Professional Modifier None Typical Low $38,904.51 Median $162,181.01 Typical High $162,181.01 | Professional | None | $38,904.51 | $162,181.01 | $162,181.01 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $4,168.69 Typical High $7,244.36 | Facility | None | $977.24 | $4,168.69 | $7,244.36 |
Moda Health Setting Professional Modifier None Typical Low $4,466.84 Median $4,897.79 Typical High $6,760.83 | Professional | None | $4,466.84 | $4,897.79 | $6,760.83 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $645.65 Typical High $4,073.80 | Professional | None | $89.13 | $645.65 | $4,073.80 |
Providence Setting Facility Modifier None Typical Low $4,365.16 Median $5,248.07 Typical High $7,079.46 | Facility | None | $4,365.16 | $5,248.07 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $7,585.78 Typical High $14,454.40 | Professional | None | $60.26 | $7,585.78 | $14,454.40 |
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 $3,715.35 Median $5,011.87 Typical High $7,585.78 | Professional | None | $3,715.35 | $5,011.87 | $7,585.78 |
Wellpoint Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
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 $2,238.72 Median $2,454.71 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,238.72 | $2,454.71 | $2,754.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $977.24 Typical High $1,096.48 | Professional | 53 · Discontinued | $912.01 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,715.35 Typical High $4,168.69 | Professional | 54 · Surgery only | $3,388.44 | $3,715.35 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $741.31 Typical High $831.76 | Professional | 55 · Aftercare only | $676.08 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $489.78 Typical High $549.54 | Professional | 56 · Pre-op care only | $446.68 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,467.37 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,467.37 | $3,890.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,238.72 Median $2,454.71 Typical High $2,754.23 | Professional | 52 · Reduced service | $2,238.72 | $2,454.71 | $2,754.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $977.24 Typical High $1,096.48 | Professional | 53 · Discontinued | $891.25 | $977.24 | $1,096.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,715.35 Typical High $4,073.80 | Professional | 54 · Surgery only | $3,388.44 | $3,715.35 | $4,073.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $741.31 Typical High $812.83 | Professional | 55 · Aftercare only | $676.08 | $741.31 | $812.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $489.78 Typical High $549.54 | Professional | 56 · Pre-op care only | $446.68 | $489.78 | $549.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,467.37 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,467.37 | $3,801.89 |
Where Texas sits
The same service costs 8.4 times more in Wisconsin 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.
Physician feeFacility fee
WI $28,671TX $3,407
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.