How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $977 · 10th to 90th $26 to $15,488
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 $1,348.96 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,513.56 | $1,862.09 |
BCBS Texas Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,584.89 | $2,290.87 |
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 $1,318.26 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,737.80 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $15,488.17 Median $19,498.45 Typical High $19,498.45 | Professional | None | $15,488.17 | $19,498.45 | $19,498.45 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,187.76 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,513.56 | $1,995.26 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $194.98 Typical High $1,288.25 | Professional | None | $20.42 | $194.98 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,949.84 Typical High $251,188.64 | Facility | None | $812.83 | $1,949.84 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,737.80 | $2,398.83 |
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 $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $676.08 Median $741.31 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $741.31 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $269.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,202.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $741.31 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $741.31 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $302.00 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,258.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $223.87 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $165.96 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,174.90 |
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
$1,023
AK $5,495TX $1,023
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.