How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $1,000 · 10th to 90th $24 to $2,042
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 $1,479.11 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,659.59 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,737.80 | $2,570.40 |
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 $1,445.44 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,905.46 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Professional | None | $18,620.87 | $18,620.87 | $18,620.87 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $6,025.60 | Facility | None | $1,000.00 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,659.59 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $213.80 Typical High $1,412.54 | Professional | None | $20.42 | $213.80 | $1,412.54 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $251,188.64 | Facility | None | $812.83 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,905.46 | $2,570.40 |
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 $1,202.26 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,659.59 | $2,570.40 |
Wellpoint Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $741.31 Median $812.83 Typical High $933.25 | Professional | 52 · Reduced service | $741.31 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $295.12 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $281.84 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $812.83 Typical High $912.01 | Professional | 52 · Reduced service | $741.31 | $812.83 | $912.01 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $363.08 | Professional | 53 · Discontinued | $295.12 | $331.13 | $363.08 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,230.27 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,230.27 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $181.97 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $181.97 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,148.15 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,148.15 | $1,288.25 |
Where Texas sits
The same service costs 5.6 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
$1,072
AK $6,026TX $1,072
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.