How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $933 · 10th to 90th $105 to $1,698
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 $1,348.96 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,445.44 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,621.81 | $3,019.95 |
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 $1,174.90 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,698.24 | $2,089.30 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $12,302.69 Typical High $12,302.69 | Professional | None | $11,748.98 | $12,302.69 | $12,302.69 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,137.96 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,137.96 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,445.44 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $223.87 Typical High $1,288.25 | Professional | None | $95.50 | $223.87 | $1,288.25 |
Oscar Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $4,677.35 | Professional | None | $1,412.54 | $2,630.27 | $4,677.35 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,862.09 Typical High $251,188.64 | Facility | None | $812.83 | $1,862.09 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,698.24 | $2,041.74 |
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 $1,122.02 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,445.44 | $2,089.30 |
Wellpoint Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $676.08 Median $724.44 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $338.84 | Professional | 53 · Discontinued | $269.15 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $251.19 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $724.44 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $269.15 | $288.40 | $309.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,096.48 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,000.00 | $1,096.48 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $154.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,023.29 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $933.25 | $1,023.29 | $1,071.52 |
Where Texas sits
The same service costs 5.2 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
$933
AK $4,898TX $933
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.