How much rates vary
Facilitymedian $1,862 · 10th to 90th $501 to $10,471Professionalmedian $724 · 10th to 90th $60 to $1,230
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 $977.24 Median $1,047.13 Typical High $1,288.25 | Professional | None | $977.24 | $1,047.13 | $1,288.25 |
BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,584.89 | Professional | None | $912.01 | $1,148.15 | $1,584.89 |
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 $831.76 Median $1,174.90 Typical High $1,479.11 | Professional | None | $831.76 | $1,174.90 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $8,709.64 | Professional | None | $7,079.46 | $7,079.46 | $8,709.64 |
Moda Health Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $6,025.60 | Facility | None | $954.99 | $1,905.46 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,288.25 | Professional | None | $977.24 | $1,047.13 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $177.83 Typical High $977.24 | Professional | None | $56.23 | $177.83 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $1,023.29 Median $3,548.13 Typical High $3,715.35 | Professional | None | $1,023.29 | $3,548.13 | $3,715.35 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,479.11 Typical High $251,188.64 | Facility | None | $758.58 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,445.44 | Professional | None | $831.76 | $1,202.26 | $1,445.44 |
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 $794.33 Median $1,023.29 Typical High $1,479.11 | Professional | None | $794.33 | $1,023.29 | $1,479.11 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $478.63 Median $524.81 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $776.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $831.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $524.81 Typical High $549.54 | Professional | 52 · Reduced service | $478.63 | $524.81 | $549.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $218.78 | Professional | 53 · Discontinued | $194.98 | $208.93 | $218.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $724.44 | $776.25 | $831.76 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $165.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $109.65 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $109.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $676.08 | $724.44 | $776.25 |
Where Texas sits
The same service costs 4.9 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
$724
AK $3,548TX $724
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.