How much rates vary
Facilitymedian $1,995 · 10th to 90th $603 to $5,248Professionalmedian $240 · 10th to 90th $38 to $457
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $707.95 | Professional | None | $309.03 | $338.84 | $707.95 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
BCBS Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $691.83 | Professional | None | $309.03 | $407.38 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,258.93 Typical High $2,691.53 | Facility | None | $660.69 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $562.34 | Professional | None | $338.84 | $380.19 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,905.46 Typical High $5,623.41 | Facility | None | $371.54 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $478.63 | Professional | None | $309.03 | $338.84 | $478.63 |
Molina Setting Professional Modifier None Typical Low $36.31 Median $199.53 Typical High $302.00 | Professional | None | $36.31 | $199.53 | $302.00 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,318.26 Typical High $251,188.64 | Facility | None | $478.63 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $575.44 | Professional | None | $338.84 | $389.05 | $575.44 |
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 $263.03 Median $346.74 Typical High $537.03 | Professional | None | $263.03 | $346.74 | $537.03 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
13 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 $154.88 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $61.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $229.09 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $275.42 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 59 · Distinct service | $269.15 | $269.15 | $269.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $154.88 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $61.66 | $67.61 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $229.09 | $257.04 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $39.81 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $213.80 | $239.88 | $275.42 |
Where Texas sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 50th of 51
$257
AK $1,380UT $240
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.