How much rates vary
Facilitymedian $2,291 · 10th to 90th $490 to $10,471Professionalmedian $437 · 10th to 90th $56 to $3,388
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 $2,089.30 Median $2,344.23 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,344.23 | $3,090.30 |
BCBS Texas Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $5,370.32 | Professional | None | $2,041.74 | $2,818.38 | $5,370.32 |
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 $2,691.53 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,090.30 | $4,365.16 |
Lucent Health Setting Professional Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $22,387.21 | Professional | None | $18,197.01 | $18,197.01 | $22,387.21 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,019.95 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,344.23 | $3,630.78 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $354.81 Typical High $2,290.87 | Professional | None | $51.29 | $354.81 | $2,290.87 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,398.83 Typical High $251,188.64 | Facility | None | $812.83 | $2,398.83 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,691.53 | $3,090.30 | $4,365.16 |
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 $2,041.74 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,041.74 | $2,754.23 | $4,265.80 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,047.13 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $457.09 Typical High $537.03 | Professional | 53 · Discontinued | $416.87 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,862.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,047.13 | $1,148.15 | $1,348.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $457.09 Typical High $537.03 | Professional | 53 · Discontinued | $416.87 | $457.09 | $537.03 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,995.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $407.38 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $407.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $208.93 | $229.09 | $269.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,862.09 |
Where Texas sits
The same service costs 17.0 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
$617
AK $10,471TX $617
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.