How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $955 · 10th to 90th $25 to $12,303
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 $1,318.26 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,479.11 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,548.82 | $2,511.89 |
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 $1,288.25 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,698.24 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $12,302.69 Median $12,589.25 Typical High $12,589.25 | Professional | None | $12,302.69 | $12,589.25 | $12,589.25 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,187.76 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,479.11 | $1,949.84 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $194.98 Typical High $1,288.25 | Professional | None | $20.42 | $194.98 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,862.09 Typical High $251,188.64 | Facility | None | $812.83 | $1,862.09 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,698.24 | $2,398.83 |
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 $1,071.52 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,513.56 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $660.69 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $338.84 | Professional | 53 · Discontinued | $263.03 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $741.31 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $295.12 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,148.15 |
Where Texas sits
The same service costs 5.4 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
$1,000
AK $5,370TX $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.