How much rates vary
Facilitymedian $2,138 · 10th to 90th $501 to $10,471Professionalmedian $1,514 · 10th to 90th $138 to $3,020
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 $2,041.74 Median $2,290.87 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,290.87 | $2,818.38 |
BCBS Texas Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,398.83 | $4,168.69 |
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 $1,949.84 Median $2,630.27 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,630.27 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $23,988.33 | Professional | None | $23,988.33 | $23,988.33 | $23,988.33 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,951.21 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,951.21 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,290.87 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $338.84 Typical High $1,949.84 | Professional | None | $117.49 | $338.84 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $251,188.64 | Facility | None | $812.83 | $2,290.87 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,630.27 | $3,715.35 |
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 $1,737.80 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,737.80 | $2,344.23 | $3,630.78 |
Wellpoint Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,023.29 Median $1,122.02 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $457.09 Typical High $524.81 | Professional | 53 · Discontinued | $407.38 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $389.05 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $229.09 Typical High $263.03 | Professional | 56 · Pre-op care only | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $1,819.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,122.02 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,023.29 | $1,122.02 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $457.09 Typical High $512.86 | Professional | 53 · Discontinued | $407.38 | $457.09 | $512.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,698.24 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,698.24 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $338.84 Typical High $380.19 | Professional | 55 · Aftercare only | $309.03 | $338.84 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 56 · Pre-op care only | $204.17 | $229.09 | $257.04 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,584.89 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,584.89 | $1,778.28 |
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
$1,549
AK $8,318TX $1,549
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.