How much rates vary
Facilitymedian $2,138 · 10th to 90th $501 to $10,471Professionalmedian $1,230 · 10th to 90th $30 to $2,512
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 $1,905.46 Median $2,137.96 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,137.96 | $2,454.71 |
BCBS Texas Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,778.28 | $2,238.72 | $3,162.28 |
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 $1,819.70 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,454.71 | $3,388.44 |
Lucent Health Setting Professional Modifier None Typical Low $25,703.96 Median $25,703.96 Typical High $25,703.96 | Professional | None | $25,703.96 | $25,703.96 | $25,703.96 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,754.23 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,905.46 | $2,137.96 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $269.15 Typical High $1,819.70 | Professional | None | $26.30 | $269.15 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,137.96 Typical High $251,188.64 | Facility | None | $812.83 | $2,137.96 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,454.71 | $3,388.44 |
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 $2,137.96 Typical High $3,311.31 | Professional | None | $1,621.81 | $2,137.96 | $3,311.31 |
Wellpoint Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $954.99 Median $1,047.13 Typical High $1,202.26 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $489.78 | Professional | 53 · Discontinued | $380.19 | $426.58 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $363.08 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,698.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,174.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $426.58 | $467.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,778.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $354.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $234.42 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,659.59 |
Where Texas sits
The same service costs 6.0 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
$1,288
AK $7,762TX $1,288
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.