How much rates vary
Facilitymedian $1,862 · 10th to 90th $692 to $5,623Professionalmedian $135 · 10th to 90th $17 to $692
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 $707.95 Median $2,290.87 Typical High $6,918.31 | Facility | None | $707.95 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $1,071.52 | Professional | None | $562.34 | $602.56 | $1,071.52 |
Christus Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,548.82 Typical High $2,041.74 | Facility | None | $457.09 | $1,548.82 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $758.58 | Professional | None | $512.86 | $562.34 | $758.58 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,168.69 | Professional | None | $3,981.07 | $3,981.07 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $1,778.28 Typical High $5,248.07 | Facility | None | $501.19 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $794.33 | Professional | None | $562.34 | $602.56 | $794.33 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $83.18 Typical High $436.52 | Professional | None | $15.14 | $83.18 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,096.48 | Professional | None | $489.78 | $891.25 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $1,548.82 Typical High $3,801.89 | Facility | None | $478.63 | $1,548.82 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $758.58 | Professional | None | $512.86 | $562.34 | $758.58 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $794.33 | Professional | None | $407.38 | $537.03 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | None | $478.63 | $489.78 | $489.78 |
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 $281.84 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $416.87 | $457.09 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $302.00 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $302.00 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $120.23 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $457.09 Typical High $562.34 | Professional | 54 · Surgery only | $416.87 | $457.09 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $74.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $426.58 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $389.05 | $426.58 | $524.81 |
Where Texas sits
The same service costs 8.3 times more in Wyoming 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
$302
WY $2,512TX $302
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.