How much rates vary
Facilitymedian $759 · 10th to 90th $355 to $3,890Professionalmedian $263 · 10th to 90th $18 to $537
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 $436.52 Median $3,715.35 Typical High $9,120.11 | Facility | None | $436.52 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $489.78 | Professional | None | $281.84 | $371.54 | $489.78 |
Christus Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $426.58 Typical High $1,412.54 | Facility | None | $316.23 | $426.58 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $724.44 | Professional | None | $354.81 | $489.78 | $724.44 |
Lucent Health Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,073.80 | Professional | None | $3,548.13 | $3,548.13 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $323.59 Median $812.83 Typical High $5,248.07 | Facility | None | $323.59 | $812.83 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $524.81 | Professional | None | $281.84 | $371.54 | $524.81 |
Molina Setting Professional Modifier None Typical Low $16.22 Median $77.62 Typical High $416.87 | Professional | None | $16.22 | $77.62 | $416.87 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $489.78 Typical High $3,801.89 | Facility | None | $338.84 | $489.78 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $724.44 | Professional | None | $354.81 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $724.44 | Professional | None | $338.84 | $489.78 | $724.44 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $141.25 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $141.25 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $56.23 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $354.81 | Professional | 54 · Surgery only | $208.93 | $281.84 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $70.79 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $28.18 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $263.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $194.98 | $263.03 | $331.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $141.25 | $186.21 | $234.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $56.23 | $75.86 | $93.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $281.84 Typical High $354.81 | Professional | 54 · Surgery only | $208.93 | $281.84 | $354.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $56.23 Typical High $70.79 | Professional | 55 · Aftercare only | $41.69 | $56.23 | $70.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $37.15 Typical High $46.77 | Professional | 56 · Pre-op care only | $28.18 | $37.15 | $46.77 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $263.03 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $194.98 | $263.03 | $331.13 |
Where Texas sits
The same service costs 5.1 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
$295
AK $1,514TX $295
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.