How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,622 to $8,318Professionalmedian $513 · 10th to 90th $155 to $2,570
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 $1,000.00 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $2,137.96 Typical High $2,884.03 | Professional | None | $446.68 | $2,137.96 | $2,884.03 |
BCBS Texas Setting Facility Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $5,495.41 | Facility | None | $1,737.80 | $2,238.72 | $5,495.41 |
BCBS Texas Setting Professional Modifier None Typical Low $407.38 Median $1,621.81 Typical High $2,570.40 | Professional | None | $407.38 | $1,621.81 | $2,570.40 |
Christus Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Facility | None | $4,365.16 | $4,365.16 | $4,365.16 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,073.80 Typical High $5,754.40 | Facility | None | $758.58 | $4,073.80 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $1,819.70 Typical High $3,090.30 | Professional | None | $416.87 | $1,819.70 | $3,090.30 |
Lucent Health Setting Professional Modifier None Typical Low $14,454.40 Median $18,197.01 Typical High $18,197.01 | Professional | None | $14,454.40 | $18,197.01 | $18,197.01 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $6,760.83 | Facility | None | $537.03 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $1,819.70 Typical High $2,884.03 | Professional | None | $446.68 | $1,819.70 | $2,884.03 |
Molina Setting Professional Modifier None Typical Low $60.26 Median $338.84 Typical High $1,819.70 | Professional | None | $60.26 | $338.84 | $1,819.70 |
Providence Setting Facility Modifier None Typical Low $616.60 Median $3,890.45 Typical High $5,623.41 | Facility | None | $616.60 | $3,890.45 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $416.87 Median $1,819.70 Typical High $3,090.30 | Professional | None | $416.87 | $1,819.70 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $363.08 Median $1,318.26 Typical High $2,818.38 | Professional | None | $363.08 | $1,318.26 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,995.26 | $2,089.30 | $2,089.30 |
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 $223.87 Median $812.83 Typical High $1,445.44 | Professional | 52 · Reduced service | $223.87 | $812.83 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $331.13 Typical High $575.44 | Professional | 53 · Discontinued | $89.13 | $331.13 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $1,230.27 Typical High $2,137.96 | Professional | 54 · Surgery only | $331.13 | $1,230.27 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $245.47 Typical High $426.58 | Professional | 55 · Aftercare only | $66.07 | $245.47 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $165.96 Typical High $288.40 | Professional | 56 · Pre-op care only | $44.67 | $165.96 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,148.15 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $309.03 | $1,148.15 | $1,995.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $812.83 Typical High $1,445.44 | Professional | 52 · Reduced service | $223.87 | $812.83 | $1,445.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $331.13 Typical High $575.44 | Professional | 53 · Discontinued | $89.13 | $331.13 | $575.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $1,230.27 Typical High $2,137.96 | Professional | 54 · Surgery only | $331.13 | $1,230.27 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $245.47 Typical High $426.58 | Professional | 55 · Aftercare only | $66.07 | $245.47 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $165.96 Typical High $288.40 | Professional | 56 · Pre-op care only | $44.67 | $165.96 | $288.40 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,148.15 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $309.03 | $1,148.15 | $1,995.26 |
Where Texas sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 49th of 51
$692
AK $4,898KY $501
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.