How much rates vary
Facilitymedian $2,512 · 10th to 90th $603 to $10,471Professionalmedian $251 · 10th to 90th $28 to $1,738
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 $1,513.56 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,659.59 | $2,089.30 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $3,090.30 Typical High $8,912.51 | Facility | None | $1,659.59 | $3,090.30 | $8,912.51 |
BCBS Texas Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,862.09 | $2,570.40 |
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 $1,318.26 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,318.26 | $1,905.46 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $13,182.57 | Professional | None | $12,589.25 | $12,589.25 | $13,182.57 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,398.83 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,659.59 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $26.30 Median $213.80 Typical High $1,412.54 | Professional | None | $26.30 | $213.80 | $1,412.54 |
Oscar Health Setting Professional Modifier None Typical Low $1,778.28 Median $5,370.32 Typical High $5,495.41 | Professional | None | $1,778.28 | $5,370.32 | $5,495.41 |
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 $1,318.26 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,949.84 | $2,344.23 |
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 $1,258.93 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,584.89 | $2,344.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $758.58 Median $812.83 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $281.84 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $812.83 | $870.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $331.13 | $346.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $263.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $165.96 | $173.78 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,202.26 |
Where Texas sits
The same service costs 20.9 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
$257
AK $5,370TX $257
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.