How much rates vary
Facilitymedian $2,239 · 10th to 90th $501 to $10,471Professionalmedian $1,549 · 10th to 90th $35 to $3,090
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 $2,344.23 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,344.23 | $2,630.27 | $3,090.30 |
BCBS Texas Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,187.76 | $2,754.23 | $3,890.45 |
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 $2,238.72 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,951.21 | $4,073.80 |
Lucent Health Setting Professional Modifier None Typical Low $22,908.68 Median $22,908.68 Typical High $22,908.68 | Professional | None | $22,908.68 | $22,908.68 | $22,908.68 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,090.30 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,090.30 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $3,388.44 | Professional | None | $2,344.23 | $2,630.27 | $3,388.44 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $331.13 Typical High $2,238.72 | Professional | None | $31.62 | $331.13 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,344.23 Typical High $251,188.64 | Facility | None | $812.83 | $2,344.23 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,951.21 | $4,073.80 |
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 $1,905.46 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,905.46 | $2,570.40 | $4,073.80 |
Wellpoint Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,174.90 Median $1,318.26 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | 53 · Discontinued | $478.63 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $398.11 Typical High $457.09 | Professional | 55 · Aftercare only | $354.81 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $263.03 Typical High $302.00 | Professional | 56 · Pre-op care only | $234.42 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $2,089.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,174.90 Median $1,318.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,479.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $524.81 | $588.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $2,238.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $398.11 Typical High $446.68 | Professional | 55 · Aftercare only | $354.81 | $398.11 | $446.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $263.03 Typical High $295.12 | Professional | 56 · Pre-op care only | $234.42 | $263.03 | $295.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $2,089.30 |
Where Texas sits
The same service costs 6.3 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
$1,549
AK $9,772TX $1,549
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.