How much rates vary
Facilitymedian $1,820 · 10th to 90th $490 to $10,471Professionalmedian $178 · 10th to 90th $22 to $1,318
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 $977.24 Median $3,715.35 Typical High $9,120.11 | Facility | None | $977.24 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,122.02 | Professional | None | $812.83 | $912.01 | $1,122.02 |
BCBS Texas Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,137.96 | Professional | None | $933.25 | $1,513.56 | $2,137.96 |
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 $1,000.00 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,174.90 | $1,659.59 |
Lucent Health Setting Professional Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $8,912.51 | Professional | None | $6,918.31 | $6,918.31 | $8,912.51 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $1,819.70 Typical High $6,918.31 | Facility | None | $870.96 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,380.38 | Professional | None | $812.83 | $912.01 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $144.54 Typical High $912.01 | Professional | None | $19.95 | $144.54 | $912.01 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $251,188.64 | Facility | None | $758.58 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,174.90 | $1,659.59 |
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 $794.33 Median $1,047.13 Typical High $1,621.81 | Professional | None | $794.33 | $1,047.13 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $407.38 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $162.18 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $676.08 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $724.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $446.68 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $162.18 | $177.83 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $676.08 Typical High $776.25 | Professional | 54 · Surgery only | $616.60 | $676.08 | $776.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $134.90 Typical High $154.88 | Professional | 55 · Aftercare only | $123.03 | $134.90 | $154.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $630.96 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $575.44 | $630.96 | $724.44 |
Where Texas sits
The same service costs 7.4 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
$550
AK $4,074TX $550
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.