How much rates vary
Facilitymedian $2,042 · 10th to 90th $501 to $10,471Professionalmedian $263 · 10th to 90th $39 to $1,862
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 $1,584.89 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,659.59 | $2,187.76 |
BCBS Texas Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,698.24 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,698.24 | $1,949.84 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $14,791.08 Median $14,791.08 Typical High $14,791.08 | Professional | None | $14,791.08 | $14,791.08 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,659.59 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $35.48 Median $223.87 Typical High $1,380.38 | Professional | None | $35.48 | $223.87 | $1,380.38 |
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 $1,698.24 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,698.24 | $1,949.84 | $3,019.95 |
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 $1,380.38 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,862.09 | $2,818.38 |
Wellpoint Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $776.25 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $831.76 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,318.26 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $831.76 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $831.76 | $954.99 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $316.23 | $331.13 | $380.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,230.27 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,230.27 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $245.47 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $165.96 Typical High $190.55 | Professional | 56 · Pre-op care only | $158.49 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,148.15 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,148.15 | $1,318.26 |
Where Texas sits
The same service costs 21.9 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
$324
AK $7,079TX $324
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.