How much rates vary
Facilitymedian $2,291 · 10th to 90th $661 to $8,710Professionalmedian $1,479 · 10th to 90th $151 to $2,818
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 $1,819.70 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,041.74 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $1,584.89 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,737.80 | $2,238.72 |
BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $3,715.35 Typical High $10,232.93 | Facility | None | $1,949.84 | $3,715.35 | $10,232.93 |
BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,778.28 | $2,884.03 |
Christus Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,737.80 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,344.23 | $3,235.94 |
Lucent Health Setting Professional Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $18,197.01 | Professional | None | $18,197.01 | $18,197.01 | $18,197.01 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $2,754.23 Typical High $6,918.31 | Facility | None | $977.24 | $2,754.23 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,819.70 | $2,041.74 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $309.03 Typical High $1,737.80 | Professional | None | $117.49 | $309.03 | $1,737.80 |
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 $1,737.80 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,344.23 | $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 $1,479.11 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,479.11 | $2,089.30 | $3,235.94 |
Wellpoint Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | 52 · Reduced service | $912.01 | $1,000.00 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $398.11 Typical High $457.09 | Professional | 53 · Discontinued | $363.08 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $302.00 Typical High $346.74 | Professional | 55 · Aftercare only | $269.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $199.53 Typical High $229.09 | Professional | 56 · Pre-op care only | $181.97 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,412.54 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,412.54 | $1,621.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $1,000.00 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,000.00 | $1,122.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $398.11 Typical High $446.68 | Professional | 53 · Discontinued | $363.08 | $398.11 | $446.68 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,513.56 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,513.56 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $302.00 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $199.53 Typical High $223.87 | Professional | 56 · Pre-op care only | $181.97 | $199.53 | $223.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,412.54 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,412.54 | $1,584.89 |
Where Texas sits
The same service costs 12.4 times more in Alabama than in Maryland. 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 $34,135MD $2,750
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.