How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,175 to $8,511Professionalmedian $288 · 10th to 90th $34 to $2,188
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 $2,754.23 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,862.09 | $2,884.03 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,698.24 | $1,905.46 | $2,884.03 |
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 $12,302.69 Median $12,302.69 Typical High $13,803.84 | Professional | None | $12,302.69 | $12,302.69 | $13,803.84 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $5,495.41 | Facility | None | $724.44 | $2,344.23 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,862.09 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $30.90 Median $223.87 Typical High $1,445.44 | Professional | None | $30.90 | $223.87 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $3,388.44 Typical High $4,897.79 | Facility | None | $660.69 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,698.24 | $1,905.46 | $2,818.38 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,819.70 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $851.14 Median $933.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,380.38 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,380.38 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $275.42 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $208.93 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,288.25 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,288.25 | $1,445.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $933.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $851.14 | $933.25 | $1,000.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $407.38 | Professional | 53 · Discontinued | $338.84 | $371.54 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,380.38 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,258.93 | $1,380.38 | $1,513.56 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $275.42 Typical High $302.00 | Professional | 55 · Aftercare only | $257.04 | $275.42 | $302.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $204.17 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $204.17 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,288.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,288.25 | $1,412.54 |
Where Texas sits
The same service costs 7.1 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
$1,000
AK $7,079TX $1,000
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.