How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $933 · 10th to 90th $87 to $1,862
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 $1,258.93 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,380.38 | $1,698.24 |
BCBS Texas Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,479.11 | $2,884.03 |
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 $1,202.26 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,584.89 | $2,238.72 |
Lucent Health Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,041.74 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,041.74 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,380.38 | $1,819.70 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $213.80 Typical High $1,202.26 | Professional | None | $79.43 | $213.80 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $251,188.64 | Facility | None | $812.83 | $1,698.24 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,584.89 | $2,187.76 |
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 $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,412.54 | $2,238.72 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $616.60 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $616.60 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $251.19 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $691.83 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $691.83 | $776.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $275.42 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,047.13 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,047.13 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $138.04 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $138.04 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $977.24 | $1,071.52 |
Where Texas sits
The same service costs 5.1 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 $5,129TX $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.