How much rates vary
Facilitymedian $2,399 · 10th to 90th $501 to $10,471Professionalmedian $646 · 10th to 90th $68 to $4,571
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 $3,890.45 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,890.45 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $5,011.87 | Professional | None | $3,981.07 | $4,365.16 | $5,011.87 |
BCBS Texas Setting Professional Modifier None Typical Low $3,801.89 Median $4,897.79 Typical High $6,760.83 | Professional | None | $3,801.89 | $4,897.79 | $6,760.83 |
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 $3,467.37 Median $4,897.79 Typical High $6,165.95 | Professional | None | $3,467.37 | $4,897.79 | $6,165.95 |
Lucent Health Setting Professional Modifier None Typical Low $33,113.11 Median $33,113.11 Typical High $34,673.69 | Professional | None | $33,113.11 | $33,113.11 | $34,673.69 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,801.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,365.16 Typical High $5,128.61 | Professional | None | $3,981.07 | $4,365.16 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $549.54 Typical High $3,715.35 | Professional | None | $64.57 | $549.54 | $3,715.35 |
Oscar Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Professional | None | $2,884.03 | $2,884.03 | $3,019.95 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $2,691.53 Typical High $251,188.64 | Facility | None | $851.14 | $2,691.53 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $3,467.37 Median $5,011.87 Typical High $6,165.95 | Professional | None | $3,467.37 | $5,011.87 | $6,165.95 |
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 $3,311.31 Median $4,168.69 Typical High $6,165.95 | Professional | None | $3,311.31 | $4,168.69 | $6,165.95 |
Wellpoint Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
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 $1,995.26 Median $2,137.96 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,995.26 | $2,137.96 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $870.96 Typical High $1,000.00 | Professional | 53 · Discontinued | $794.33 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,235.94 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,019.95 | $3,235.94 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $645.65 Typical High $741.31 | Professional | 55 · Aftercare only | $602.56 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | 56 · Pre-op care only | $398.11 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,019.95 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,019.95 | $3,467.37 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,995.26 Median $2,137.96 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,995.26 | $2,137.96 | $2,290.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $870.96 Typical High $912.01 | Professional | 53 · Discontinued | $794.33 | $870.96 | $912.01 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,235.94 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,019.95 | $3,235.94 | $3,388.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $645.65 Typical High $691.83 | Professional | 55 · Aftercare only | $602.56 | $645.65 | $691.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $436.52 Typical High $457.09 | Professional | 56 · Pre-op care only | $398.11 | $436.52 | $457.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $3,019.95 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,818.38 | $3,019.95 | $3,162.28 |
Where Texas sits
The same service costs 21.9 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
$646
AK $14,125TX $646
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.