How much rates vary
Facilitymedian $3,236 · 10th to 90th $933 to $7,762Professionalmedian $417 · 10th to 90th $62 to $7,762
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 $478.63 Median $537.03 Typical High $4,168.69 | Professional | None | $478.63 | $537.03 | $4,168.69 |
Christus Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,884.03 Typical High $3,801.89 | Facility | None | $870.96 | $2,884.03 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $831.76 | Professional | None | $501.19 | $588.84 | $831.76 |
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 $7,762.47 Median $7,762.47 Typical High $7,762.47 | Professional | None | $7,762.47 | $7,762.47 | $7,762.47 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $2,511.89 Typical High $6,760.83 | Facility | None | $537.03 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $870.96 | Professional | None | $478.63 | $537.03 | $870.96 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $323.59 Typical High $489.78 | Professional | None | $52.48 | $323.59 | $489.78 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,951.21 Typical High $6,760.83 | Facility | None | $758.58 | $2,951.21 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $831.76 | Professional | None | $501.19 | $588.84 | $831.76 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,332.54 | Facility | None | $1,698.24 | $4,570.88 | $9,332.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $812.83 | Professional | None | $389.05 | $524.81 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
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 $239.88 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $263.03 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $104.71 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $398.11 Typical High $436.52 | Professional | 54 · Surgery only | $354.81 | $398.11 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $58.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $371.54 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $331.13 | $371.54 | $407.38 |
Where Texas sits
The same service costs 5.4 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
$490
AK $2,630TX $490
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.