How much rates vary
Facilitymedian $1,820 · 10th to 90th $501 to $10,471Professionalmedian $195 · 10th to 90th $29 to $1,230
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 $3,715.35 Typical High $9,120.11 | Facility | None | $977.24 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $891.25 | $1,000.00 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,621.81 | Professional | None | $954.99 | $1,230.27 | $1,621.81 |
Lucent Health Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $9,772.37 | Professional | None | $9,549.93 | $9,549.93 | $9,772.37 |
Moda Health Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $6,918.31 | Facility | None | $912.01 | $1,862.09 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,380.38 | Professional | None | $891.25 | $1,023.29 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $27.54 Median $169.82 Typical High $1,023.29 | Professional | None | $27.54 | $169.82 | $1,023.29 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $251,188.64 | Facility | None | $812.83 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,621.81 | Professional | None | $954.99 | $1,230.27 | $1,621.81 |
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 $741.31 Median $1,023.29 Typical High $1,513.56 | Professional | None | $741.31 | $1,023.29 | $1,513.56 |
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 $446.68 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $501.19 Typical High $562.34 | Professional | 52 · Reduced service | $446.68 | $501.19 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $199.53 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $676.08 | $758.58 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $794.33 |
Where Texas sits
The same service costs 21.9 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
$204
AK $4,467TX $204
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.