How much rates vary
Facilitymedian $1,905 · 10th to 90th $501 to $10,471Professionalmedian $776 · 10th to 90th $83 to $1,778
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 $1,122.02 Median $1,122.02 Typical High $1,513.56 | Professional | None | $1,122.02 | $1,122.02 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,096.48 | $1,318.26 |
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 $1,318.26 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,318.26 | $1,995.26 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,709.64 | Professional | None | $8,317.64 | $8,317.64 | $8,709.64 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,995.26 Typical High $6,918.31 | Facility | None | $977.24 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $1,023.29 | Professional | None | $79.43 | $181.97 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,548.82 Typical High $251,188.64 | Facility | None | $812.83 | $1,548.82 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,318.26 | $1,995.26 |
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 $912.01 Median $1,230.27 Typical High $1,905.46 | Professional | None | $912.01 | $1,230.27 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $562.34 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $933.25 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $562.34 | $562.34 | $676.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $223.87 | $229.09 | $269.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $851.14 | $1,000.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $134.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $933.25 |
Where Texas sits
The same service costs 5.9 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
$794
AK $4,677TX $794
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.