How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,000 to $9,772Professionalmedian $148 · 10th to 90th $23 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 $1,000.00 Median $3,801.89 Typical High $10,232.93 | Facility | None | $1,000.00 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $831.76 | Professional | None | $562.34 | $616.60 | $831.76 |
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 $758.58 Median $2,041.74 Typical High $2,754.23 | Facility | None | $758.58 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,023.29 | Professional | None | $616.60 | $758.58 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,370.32 | Professional | None | $5,248.07 | $5,248.07 | $5,370.32 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $2,454.71 Typical High $6,918.31 | Facility | None | $645.65 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $831.76 | Professional | None | $562.34 | $630.96 | $831.76 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $114.82 Typical High $562.34 | Professional | None | $21.88 | $114.82 | $562.34 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,041.74 Typical High $2,754.23 | Facility | None | $630.96 | $2,041.74 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,023.29 | Professional | None | $616.60 | $758.58 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | None | $524.81 | $676.08 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $275.42 Median $309.03 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $416.87 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $107.15 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $501.19 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $309.03 Typical High $346.74 | Professional | 52 · Reduced service | $275.42 | $309.03 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $141.25 | Professional | 53 · Discontinued | $112.20 | $123.03 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $457.09 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $91.20 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $91.20 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $61.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $56.23 | $61.66 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $489.78 |
Where Texas sits
The same service costs 16.6 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
$166
AK $2,754TX $166
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.