How much rates vary
Facilitymedian $1,230 · 10th to 90th $479 to $4,786Professionalmedian $166 · 10th to 90th $23 to $1,072
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,122.02 | Professional | None | $776.25 | $891.25 | $1,122.02 |
Christus Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,691.53 | Facility | None | $478.63 | $645.65 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,412.54 | Professional | None | $831.76 | $1,096.48 | $1,412.54 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,511.38 | Professional | None | $6,606.93 | $6,606.93 | $8,511.38 |
Moda Health Setting Facility Modifier None Typical Low $776.25 Median $2,290.87 Typical High $6,025.60 | Facility | None | $776.25 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,230.27 | Professional | None | $776.25 | $891.25 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $21.38 Median $141.25 Typical High $912.01 | Professional | None | $21.38 | $141.25 | $912.01 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $6,165.95 | Facility | None | $537.03 | $870.96 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,412.54 | Professional | None | $831.76 | $1,096.48 | $1,412.54 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,235.94 | Facility | None | $389.05 | $1,288.25 | $3,235.94 |
United Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,318.26 | Professional | None | $660.69 | $870.96 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $389.05 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $389.05 | $436.52 | $501.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $173.78 | $199.53 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $588.84 | $660.69 | $741.31 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $117.49 | $131.83 | $147.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $549.54 | $616.60 | $691.83 |
Where Texas sits
The same service costs 22.4 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
$178
AK $3,981TX $178
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.