How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,122 to $9,333Professionalmedian $214 · 10th to 90th $35 to $1,047
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 $1,000.00 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,148.15 | Professional | None | $794.33 | $891.25 | $1,148.15 |
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 $870.96 Median $2,041.74 Typical High $3,311.31 | Facility | None | $870.96 | $2,041.74 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,479.11 | Professional | None | $870.96 | $1,071.52 | $1,479.11 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,585.78 | Professional | None | $7,244.36 | $7,244.36 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $870.96 Median $2,511.89 Typical High $6,760.83 | Facility | None | $870.96 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,148.15 | Professional | None | $794.33 | $891.25 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $165.96 Typical High $776.25 | Professional | None | $32.36 | $165.96 | $776.25 |
Providence Setting Facility Modifier None Typical Low $870.96 Median $2,187.76 Typical High $6,760.83 | Facility | None | $870.96 | $2,187.76 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,479.11 | Professional | None | $870.96 | $1,071.52 | $1,479.11 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,548.82 | Professional | None | $741.31 | $977.24 | $1,548.82 |
Wellpoint Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $398.11 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $660.69 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $436.52 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $177.83 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $660.69 | $758.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $151.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $707.95 |
Where Texas sits
The same service costs 16.2 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
$240
AK $3,890TX $240
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.