How much rates vary
Facilitymedian $2,399 · 10th to 90th $525 to $10,471Professionalmedian $537 · 10th to 90th $60 to $955
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 $1,318.26 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,318.26 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,148.15 | Professional | None | $741.31 | $794.33 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,288.25 Typical High $2,691.53 | Facility | None | $645.65 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,174.90 | Professional | None | $660.69 | $933.25 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $6,456.54 | Professional | None | $5,495.41 | $5,495.41 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $3,235.94 Typical High $8,709.64 | Facility | None | $776.25 | $3,235.94 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,000.00 | Professional | None | $741.31 | $794.33 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $131.83 Typical High $724.44 | Professional | None | $54.95 | $131.83 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,862.09 | Professional | None | $776.25 | $1,445.44 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,318.26 Typical High $251,188.64 | Facility | None | $707.95 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,148.15 | Professional | None | $645.65 | $933.25 | $1,148.15 |
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 $602.56 Median $794.33 Typical High $1,148.15 | Professional | None | $602.56 | $794.33 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $371.54 Median $398.11 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $371.54 | $398.11 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $147.91 | $158.49 | $169.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $125.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $588.84 |
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
$537
AK $3,162TX $537
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.