How much rates vary
Facilitymedian $2,692 · 10th to 90th $550 to $10,471Professionalmedian $407 · 10th to 90th $50 to $3,020
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 $1,778.28 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,995.26 | $2,454.71 |
BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $9,332.54 | Facility | None | $2,290.87 | $4,168.69 | $9,332.54 |
BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $5,248.07 | Professional | None | $2,041.74 | $2,630.27 | $5,248.07 |
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 $2,290.87 Median $2,570.40 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,570.40 | $3,715.35 |
Lucent Health Setting Professional Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $19,054.61 | Professional | None | $15,135.61 | $15,135.61 | $19,054.61 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,818.38 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,778.28 | $1,995.26 | $2,951.21 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $309.03 Typical High $1,995.26 | Professional | None | $43.65 | $309.03 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $251,188.64 | Facility | None | $812.83 | $2,238.72 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,290.87 Median $2,570.40 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,570.40 | $3,715.35 |
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 $1,737.80 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,290.87 | $3,548.13 |
Wellpoint Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $891.25 Median $977.24 Typical High $1,122.02 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $457.09 | Professional | 53 · Discontinued | $354.81 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,479.11 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,479.11 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,380.38 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,380.38 | $1,584.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $457.09 | Professional | 53 · Discontinued | $354.81 | $389.05 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,445.44 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,445.44 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $295.12 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $295.12 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $229.09 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $229.09 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,348.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,348.96 | $1,584.89 |
Where Texas sits
The same service costs 7.2 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
$1,230
AK $8,913TX $1,230
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.