How much rates vary
Facilitymedian $1,995 · 10th to 90th $501 to $10,471Professionalmedian $832 · 10th to 90th $23 to $10,000
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,445.44 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,659.59 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,964.78 | Professional | None | $10,000.00 | $10,000.00 | $10,964.78 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,000.00 | $2,187.76 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,445.44 | $1,905.46 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $181.97 Typical High $1,202.26 | Professional | None | $20.42 | $181.97 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,862.09 Typical High $251,188.64 | Facility | None | $812.83 | $1,862.09 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,659.59 | $2,398.83 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,479.11 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $645.65 Median $724.44 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $724.44 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $331.13 | Professional | 53 · Discontinued | $257.04 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $165.96 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,148.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $724.44 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $724.44 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $288.40 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $288.40 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $144.54 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $144.54 | $162.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,122.02 |
Where Texas sits
The same service costs 5.9 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
$912
AK $5,370TX $912
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.