How much rates vary
Facilitymedian $2,399 · 10th to 90th $550 to $9,333Professionalmedian $1,096 · 10th to 90th $132 to $1,995
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 $1,621.81 Median $1,659.59 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,659.59 | $1,862.09 |
BCBS Texas Setting Facility Modifier None Typical Low $1,778.28 Median $3,235.94 Typical High $8,317.64 | Facility | None | $1,778.28 | $3,235.94 | $8,317.64 |
BCBS Texas Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,949.84 | $2,691.53 |
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 $1,412.54 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,412.54 | $2,041.74 | $2,570.40 |
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 $2,454.71 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,621.81 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $107.15 Median $275.42 Typical High $1,548.82 | Professional | None | $107.15 | $275.42 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,479.11 | $1,479.11 | $1,548.82 |
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 $1,412.54 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,412.54 | $2,041.74 | $2,511.89 |
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 $1,348.96 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,348.96 | $1,737.80 | $2,570.40 |
Wellpoint Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $812.83 Median $870.96 Typical High $1,000.00 | Professional | 52 · Reduced service | $812.83 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $407.38 | Professional | 53 · Discontinued | $323.59 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $204.17 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,412.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $812.83 Median $870.96 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $870.96 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $346.74 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,380.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $186.21 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,288.25 |
Where Texas sits
The same service costs 5.4 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
$1,096
AK $5,888TX $1,096
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.