How much rates vary
Facilitymedian $2,138 · 10th to 90th $501 to $10,471Professionalmedian $1,445 · 10th to 90th $138 to $2,951
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 $1,995.26 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,995.26 | $2,187.76 | $2,570.40 |
BCBS Texas Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $4,466.84 | Professional | None | $1,862.09 | $2,344.23 | $4,466.84 |
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 $1,905.46 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,511.89 | $3,548.13 |
Lucent Health Setting Professional Modifier None Typical Low $20,417.38 Median $20,417.38 Typical High $20,417.38 | Professional | None | $20,417.38 | $20,417.38 | $20,417.38 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,884.03 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,187.76 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $323.59 Typical High $1,905.46 | Professional | None | $107.15 | $323.59 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,041.74 Typical High $251,188.64 | Facility | None | $812.83 | $2,041.74 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,570.40 | $3,548.13 |
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 $1,621.81 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,621.81 | $2,290.87 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $398.11 | $446.68 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,659.59 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,479.11 | $1,659.59 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $331.13 Typical High $380.19 | Professional | 55 · Aftercare only | $295.12 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $446.68 Typical High $501.19 | Professional | 53 · Discontinued | $398.11 | $446.68 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,479.11 | $1,659.59 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $295.12 | $331.13 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $251.19 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,737.80 |
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
$1,514
AK $8,128TX $1,514
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.