How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $10,471Professionalmedian $1,148 · 10th to 90th $31 to $12,023
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 $1,698.24 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,862.09 | $2,344.23 |
BCBS Texas Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,548.82 | $1,949.84 | $2,754.23 |
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 $1,621.81 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,137.96 | $2,884.03 |
Lucent Health Setting Professional Modifier None Typical Low $12,022.64 Median $12,022.64 Typical High $13,803.84 | Professional | None | $12,022.64 | $12,022.64 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,862.09 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $229.09 Typical High $1,513.56 | Professional | None | $26.30 | $229.09 | $1,513.56 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $251,188.64 | Facility | None | $812.83 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,187.76 | $2,884.03 |
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 $1,380.38 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,905.46 | $2,951.21 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $831.76 Median $933.25 Typical High $1,071.52 | Professional | 52 · Reduced service | $831.76 | $933.25 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 53 · Discontinued | $338.84 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $251.19 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $213.80 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,513.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $933.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $933.25 | $1,047.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $371.54 | $416.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,412.54 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,412.54 | $1,584.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $281.84 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $281.84 | $316.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $208.93 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $208.93 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,318.26 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,318.26 | $1,479.11 |
Where Texas sits
The same service costs 7.9 times more in Alabama than in Washington. 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 $19,273WA $2,428
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.