How much rates vary
Facilitymedian $1,820 · 10th to 90th $646 to $5,495Professionalmedian $759 · 10th to 90th $81 to $1,380
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 $1,122.02 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,202.26 | $1,479.11 |
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 $977.24 Median $1,380.38 Typical High $1,737.80 | Professional | None | $977.24 | $1,380.38 | $1,737.80 |
Lucent Health Setting Professional Modifier None Typical Low $8,317.64 Median $8,317.64 Typical High $9,772.37 | Professional | None | $8,317.64 | $8,317.64 | $9,772.37 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $1,819.70 Typical High $6,918.31 | Facility | None | $977.24 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,122.02 | $1,202.26 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $1,071.52 | Professional | None | $75.86 | $186.21 | $1,071.52 |
Oscar Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | None | $741.31 | $741.31 | $776.25 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,513.56 Typical High $251,188.64 | Facility | None | $758.58 | $1,513.56 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,698.24 | Professional | None | $977.24 | $1,380.38 | $1,698.24 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,801.89 | Facility | None | $616.60 | $1,995.26 | $3,801.89 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,698.24 | Professional | None | $912.01 | $1,174.90 | $1,698.24 |
Wellpoint Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $549.54 Median $602.56 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $239.88 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $977.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $549.54 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $239.88 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $831.76 | $891.25 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $177.83 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $125.89 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $776.25 | $831.76 | $891.25 |
Where Texas sits
The same service costs 5.5 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
$776
AK $4,266TX $776
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.