How much rates vary
Facilitymedian $2,291 · 10th to 90th $490 to $10,471Professionalmedian $1,905 · 10th to 90th $219 to $3,388
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 $2,691.53 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,691.53 | $2,884.03 | $3,548.13 |
BCBS Texas Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $4,570.88 | Professional | None | $2,570.40 | $3,235.94 | $4,570.88 |
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 $2,344.23 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,344.23 | $3,311.31 | $4,365.16 |
Lucent Health Setting Professional Modifier None Typical Low $19,952.62 Median $19,952.62 Typical High $23,442.29 | Professional | None | $19,952.62 | $19,952.62 | $23,442.29 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $3,019.95 Typical High $6,918.31 | Facility | None | $977.24 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,691.53 | $2,884.03 | $3,467.37 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $457.09 Typical High $2,630.27 | Professional | None | $199.53 | $457.09 | $2,630.27 |
Oscar Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,344.23 | Professional | None | $2,238.72 | $2,238.72 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,630.27 Typical High $251,188.64 | Facility | None | $812.83 | $2,630.27 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,344.23 Median $3,388.44 Typical High $4,265.80 | Professional | None | $2,344.23 | $3,388.44 | $4,265.80 |
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 $2,238.72 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,238.72 | $2,951.21 | $4,168.69 |
Wellpoint Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
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 $1,318.26 Median $1,445.44 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $575.44 Typical High $691.83 | Professional | 53 · Discontinued | $537.03 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,137.96 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,995.26 | $2,137.96 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $436.52 Typical High $512.86 | Professional | 55 · Aftercare only | $398.11 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $288.40 Typical High $338.84 | Professional | 56 · Pre-op care only | $269.15 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,995.26 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,995.26 | $2,398.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,445.44 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,513.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $575.44 Typical High $616.60 | Professional | 53 · Discontinued | $537.03 | $575.44 | $616.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,137.96 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,995.26 | $2,137.96 | $2,290.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $436.52 Typical High $457.09 | Professional | 55 · Aftercare only | $398.11 | $436.52 | $457.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $288.40 Typical High $302.00 | Professional | 56 · Pre-op care only | $269.15 | $288.40 | $302.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,995.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,995.26 | $2,137.96 |
Where Texas sits
The same service costs 5.1 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
$1,905
AK $9,772TX $1,905
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.