How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,995 to $20,417Professionalmedian $537 · 10th to 90th $91 to $2,692
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 $2,290.87 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,511.89 | $2,951.21 |
Christus Setting Facility Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $16,982.44 | Facility | None | $16,982.44 | $16,982.44 | $16,982.44 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $15,848.93 Typical High $22,387.21 | Facility | None | $794.33 | $15,848.93 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,981.07 | Professional | None | $2,511.89 | $3,090.30 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $21,379.62 Median $21,379.62 Typical High $21,379.62 | Professional | None | $21,379.62 | $21,379.62 | $21,379.62 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,090.30 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,290.87 | $2,511.89 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $446.68 Typical High $2,238.72 | Professional | None | $85.11 | $446.68 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $15,488.17 Typical High $22,387.21 | Facility | None | $933.25 | $15,488.17 | $22,387.21 |
Providence Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,981.07 | Professional | None | $2,454.71 | $3,090.30 | $3,981.07 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $9,772.37 Typical High $21,379.62 | Facility | None | $3,981.07 | $9,772.37 | $21,379.62 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,570.40 | $3,981.07 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,122.02 Median $1,258.93 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,122.02 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 53 · Discontinued | $457.09 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,698.24 | $1,862.09 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,737.80 | $2,041.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,122.02 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,122.02 | $1,258.93 | $1,412.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $457.09 | $501.19 | $562.34 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,862.09 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,698.24 | $1,862.09 | $2,137.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $426.58 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $281.84 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,737.80 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,737.80 | $1,995.26 |
Where Texas sits
The same service costs 20.0 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
$562
AK $11,220TX $562
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.