How much rates vary
Facilitymedian $2,630 · 10th to 90th $447 to $8,511Professionalmedian $525 · 10th to 90th $59 to $3,631
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 $3,388.44 Median $3,630.78 Typical High $4,265.80 | Professional | None | $3,388.44 | $3,630.78 | $4,265.80 |
BCBS Texas Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $5,623.41 | Professional | None | $3,235.94 | $4,168.69 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,128.31 | Professional | None | $6,606.93 | $6,606.93 | $8,128.31 |
Lucent Health Setting Professional Modifier None Typical Low $25,118.86 Median $25,118.86 Typical High $29,512.09 | Professional | None | $25,118.86 | $25,118.86 | $29,512.09 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,630.78 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,630.78 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,630.78 Typical High $4,365.16 | Professional | None | $3,388.44 | $3,630.78 | $4,365.16 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $478.63 Typical High $3,162.28 | Professional | None | $56.23 | $478.63 | $3,162.28 |
Oscar Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,467.37 | Professional | None | $3,388.44 | $3,388.44 | $3,467.37 |
Providence Setting Facility Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $5,495.41 | Facility | None | $3,235.94 | $3,630.78 | $5,495.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $7,244.36 Typical High $9,549.93 | Professional | None | $79.43 | $7,244.36 | $9,549.93 |
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 $2,818.38 Median $3,630.78 Typical High $5,248.07 | Professional | None | $2,818.38 | $3,630.78 | $5,248.07 |
Wellpoint Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $1,698.24 Median $1,819.70 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,698.24 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $724.44 Typical High $851.14 | Professional | 53 · Discontinued | $676.08 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,754.23 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,511.89 | $2,754.23 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $549.54 Typical High $645.65 | Professional | 55 · Aftercare only | $501.19 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $363.08 Typical High $426.58 | Professional | 56 · Pre-op care only | $338.84 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,570.40 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,570.40 | $2,951.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $1,819.70 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,698.24 | $1,819.70 | $1,905.46 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 53 · Discontinued | $676.08 | $724.44 | $776.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,754.23 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,511.89 | $2,754.23 | $2,884.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $549.54 Typical High $575.44 | Professional | 55 · Aftercare only | $501.19 | $549.54 | $575.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $363.08 Typical High $389.05 | Professional | 56 · Pre-op care only | $338.84 | $363.08 | $389.05 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,570.40 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,570.40 | $2,691.53 |
Where Texas sits
The same service costs 27.5 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
$525
AK $14,454TX $525
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.