How much rates vary
Facilitymedian $1,023 · 10th to 90th $331 to $3,981Professionalmedian $257 · 10th to 90th $36 to $407
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $407.38 | Professional | None | $194.98 | $346.74 | $407.38 |
Christus Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $2,290.87 | Facility | None | $295.12 | $416.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $467.74 | Professional | None | $204.17 | $288.40 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,311.31 | Professional | None | $2,570.40 | $2,570.40 | $3,311.31 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $1,000.00 Typical High $4,677.35 | Facility | None | $204.17 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $398.11 | Professional | None | $194.98 | $338.84 | $398.11 |
Molina Setting Professional Modifier None Typical Low $32.36 Median $218.78 Typical High $363.08 | Professional | None | $32.36 | $218.78 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | None | $245.47 | $245.47 | $257.04 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $389.05 Typical High $1,995.26 | Facility | None | $275.42 | $389.05 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $467.74 | Professional | None | $204.17 | $288.40 | $467.74 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $407.38 | Professional | None | $158.49 | $257.04 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $97.72 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $97.72 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $38.90 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $144.54 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $29.51 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.50 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $134.90 | $234.42 | $281.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $97.72 | $165.96 | $194.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $66.07 Typical High $79.43 | Professional | 53 · Discontinued | $38.90 | $66.07 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $144.54 | $251.19 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $29.51 | $50.12 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $33.11 Typical High $39.81 | Professional | 56 · Pre-op care only | $19.50 | $33.11 | $39.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $134.90 | $234.42 | $275.42 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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· 46th of 51
$257
AK $813KY $234
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.