How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,072 to $12,303Professionalmedian $178 · 10th to 90th $29 to $891
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 $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,047.13 | Professional | None | $691.83 | $758.58 | $1,047.13 |
Christus Setting Facility Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $8,317.64 | Facility | None | $8,317.64 | $8,317.64 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $7,762.47 Typical High $10,964.78 | Facility | None | $954.99 | $7,762.47 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,288.25 | Professional | None | $758.58 | $933.25 | $1,288.25 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,606.93 | Professional | None | $6,309.57 | $6,309.57 | $6,606.93 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $6,918.31 | Facility | None | $758.58 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,047.13 | Professional | None | $691.83 | $776.25 | $1,047.13 |
Molina Setting Professional Modifier None Typical Low $26.92 Median $138.04 Typical High $676.08 | Professional | None | $26.92 | $138.04 | $676.08 |
Oscar Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,818.38 | $2,951.21 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $7,413.10 Typical High $11,220.18 | Facility | None | $891.25 | $7,413.10 | $11,220.18 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,288.25 | Professional | None | $758.58 | $933.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $6,025.60 Typical High $15,135.61 | Facility | None | $2,187.76 | $6,025.60 | $15,135.61 |
United Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,288.25 | Professional | None | $645.65 | $831.76 | $1,288.25 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $346.74 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $512.86 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $380.19 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $151.36 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $575.44 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $602.56 |
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
$209
AK $3,388TX $209
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.