How much rates vary
Facilitymedian $2,692 · 10th to 90th $562 to $10,965Professionalmedian $1,318 · 10th to 90th $31 to $4,467
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 $1,862.09 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,089.30 | $2,630.27 |
BCBS Texas Setting Facility Modifier None Typical Low $2,089.30 Median $3,801.89 Typical High $19,952.62 | Facility | None | $2,089.30 | $3,801.89 | $19,952.62 |
BCBS Texas Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,737.80 | $2,187.76 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,398.83 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $13,489.63 Median $15,488.17 Typical High $15,488.17 | Professional | None | $13,489.63 | $15,488.17 | $15,488.17 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $2,691.53 Typical High $6,918.31 | Facility | None | $977.24 | $2,691.53 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,089.30 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $257.04 Typical High $1,737.80 | Professional | None | $26.30 | $257.04 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $251,188.64 | Facility | None | $758.58 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,398.83 | $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 $2,238.72 Typical High $3,311.31 | Professional | None | $1,513.56 | $2,238.72 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $933.25 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $416.87 Typical High $478.63 | Professional | 53 · Discontinued | $371.54 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $354.81 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $186.21 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,659.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,047.13 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $1,047.13 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $416.87 Typical High $457.09 | Professional | 53 · Discontinued | $371.54 | $416.87 | $457.09 |
Moda Health 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 |
Moda Health 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 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $208.93 | $229.09 |
Moda Health 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 |
Where Texas sits
The same service costs 8.0 times more in Alabama than in Washington. 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
AL $20,353WA $2,540
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.