How much rates vary
Facilitymedian $1,950 · 10th to 90th $501 to $10,471Professionalmedian $871 · 10th to 90th $105 to $1,585
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 $1,288.25 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,380.38 | $1,737.80 |
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 $1,122.02 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,621.81 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $11,220.18 | Professional | None | $9,549.93 | $9,549.93 | $11,220.18 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,000.00 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,380.38 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $1,230.27 | Professional | None | $93.33 | $213.80 | $1,230.27 |
Oscar Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,202.26 | $1,202.26 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,659.59 Typical High $251,188.64 | Facility | None | $812.83 | $1,659.59 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,621.81 | $1,995.26 |
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 $1,071.52 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,380.38 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $645.65 Median $691.83 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $257.04 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $162.18 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $1,122.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $645.65 | $691.83 | $741.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,047.13 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,047.13 | $1,096.48 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $218.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $147.91 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $977.24 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $977.24 | $1,023.29 |
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
$871
AK $4,677TX $871
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.