How much rates vary
Facilitymedian $2,138 · 10th to 90th $501 to $10,471Professionalmedian $1,514 · 10th to 90th $36 to $16,218
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 $2,290.87 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,511.89 | $2,951.21 |
BCBS Texas Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,691.53 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,630.78 | Professional | None | $2,290.87 | $2,754.23 | $3,630.78 |
Lucent Health Setting Professional Modifier None Typical Low $16,218.10 Median $16,218.10 Typical High $18,620.87 | Professional | None | $16,218.10 | $16,218.10 | $18,620.87 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,630.27 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,630.27 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,511.89 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $309.03 Typical High $2,089.30 | Professional | None | $31.62 | $309.03 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $251,188.64 | Facility | None | $812.83 | $2,238.72 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,691.53 | $3,715.35 |
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 $1,737.80 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,737.80 | $2,344.23 | $3,715.35 |
Wellpoint Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,148.15 Median $1,258.93 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,148.15 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 53 · Discontinued | $457.09 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,905.46 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,698.24 | $1,905.46 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $2,041.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,148.15 | $1,258.93 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $457.09 | $501.19 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,905.46 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $1,905.46 | $2,089.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,778.28 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,778.28 | $1,949.84 |
Where Texas sits
The same service costs 6.2 times more in Alaska than in Delaware. 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· 50th of 51
$1,585
AK $9,333DE $1,514
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.