How much rates vary
Facilitymedian $2,291 · 10th to 90th $550 to $10,471Professionalmedian $1,000 · 10th to 90th $66 to $9,120
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 $1,445.44 Median $1,584.89 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,584.89 | $1,995.26 |
BCBS Texas Setting Facility Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $9,772.37 | Facility | None | $1,548.82 | $2,884.03 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,513.56 | $2,454.71 |
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 $1,230.27 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,778.28 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,715.19 | Professional | None | $9,120.11 | $9,120.11 | $10,715.19 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,290.87 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,584.89 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $18.62 Median $199.53 Typical High $1,230.27 | Professional | None | $18.62 | $199.53 | $1,230.27 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $251,188.64 | Facility | None | $758.58 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,778.28 | $2,570.40 |
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 $1,148.15 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,148.15 | $1,584.89 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $724.44 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $794.33 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $794.33 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $794.33 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $316.23 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,258.93 |
Where Texas sits
The same service costs 9.1 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 $18,978MD $2,076
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.