How much rates vary
Facilitymedian $3,311 · 10th to 90th $708 to $7,244Professionalmedian $380 · 10th to 90th $56 to $2,951
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $3,311.31 | Professional | None | $416.87 | $457.09 | $3,311.31 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $660.69 | Professional | None | $380.19 | $478.63 | $660.69 |
Christus Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,311.31 Typical High $4,786.30 | Facility | None | $602.56 | $3,311.31 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $660.69 | Professional | None | $380.19 | $512.86 | $660.69 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,548.13 | Professional | None | $2,951.21 | $2,951.21 | $3,548.13 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $1,905.46 Typical High $5,623.41 | Facility | None | $467.74 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $741.31 | Professional | None | $416.87 | $457.09 | $741.31 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $281.84 Typical High $389.05 | Professional | None | $51.29 | $281.84 | $389.05 |
Providence Setting Facility Modifier None Typical Low $549.54 Median $3,311.31 Typical High $4,786.30 | Facility | None | $549.54 | $3,311.31 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $660.69 | Professional | None | $380.19 | $524.81 | $660.69 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $676.08 | Professional | None | $316.23 | $426.58 | $676.08 |
Wellpoint Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $204.17 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $223.87 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $354.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $223.87 Typical High $251.19 | Professional | 52 · Reduced service | $204.17 | $223.87 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $100.00 | Professional | 53 · Discontinued | $83.18 | $91.20 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $380.19 | Professional | 54 · Surgery only | $309.03 | $338.84 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $50.12 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $316.23 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $288.40 | $316.23 | $354.81 |
Where Texas sits
The same service costs 5.4 times more in Alaska than in New York. 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· 49th of 51
$457
AK $2,239NY $417
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.