How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $257 · 10th to 90th $28 to $2,042
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 $1,479.11 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,548.82 | $2,041.74 |
BCBS Texas Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,584.89 | $2,089.30 |
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 $1,584.89 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,819.70 | $2,818.38 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,302.69 | Professional | None | $11,748.98 | $11,748.98 | $12,302.69 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,290.87 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,290.87 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,548.82 | $2,137.96 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $204.17 Typical High $1,318.26 | Professional | None | $25.12 | $204.17 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $251,188.64 | Facility | None | $812.83 | $1,995.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,584.89 | $1,819.70 | $2,754.23 |
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 $1,288.25 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,737.80 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $741.31 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $177.83 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,258.93 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $776.25 Typical High $891.25 | Professional | 52 · Reduced service | $741.31 | $776.25 | $891.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $309.03 | $354.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,348.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $234.42 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $234.42 | $269.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $154.88 Typical High $177.83 | Professional | 56 · Pre-op care only | $147.91 | $154.88 | $177.83 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,258.93 |
Where Texas sits
The same service costs 7.8 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
$851
AK $6,607TX $851
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.