How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $7,244Professionalmedian $135 · 10th to 90th $21 to $724
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $794.33 | Professional | None | $537.03 | $588.84 | $794.33 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,691.53 | Facility | None | $602.56 | $2,041.74 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $977.24 | Professional | None | $575.44 | $724.44 | $977.24 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,248.07 | Professional | None | $4,677.35 | $4,677.35 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $1,905.46 Typical High $5,495.41 | Facility | None | $616.60 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $794.33 | Professional | None | $537.03 | $602.56 | $794.33 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $104.71 Typical High $562.34 | Professional | None | $19.05 | $104.71 | $562.34 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $4,466.84 | Facility | None | $602.56 | $2,041.74 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $977.24 | Professional | None | $575.44 | $724.44 | $977.24 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $977.24 | Professional | None | $489.78 | $630.96 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $263.03 Median $295.12 Typical High $338.84 | Professional | 52 · Reduced service | $263.03 | $295.12 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $295.12 Typical High $331.13 | Professional | 52 · Reduced service | $263.03 | $295.12 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $117.49 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $436.52 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $467.74 |
Where Texas sits
The same service costs 18.6 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
$141
AK $2,630TX $141
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.