How much rates vary
Facilitymedian $2,399 · 10th to 90th $501 to $10,471Professionalmedian $603 · 10th to 90th $63 to $4,266
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 $3,890.45 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,890.45 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $4,570.88 | Professional | None | $3,715.35 | $3,981.07 | $4,570.88 |
BCBS Texas Setting Professional Modifier None Typical Low $3,548.13 Median $4,466.84 Typical High $6,165.95 | Professional | None | $3,548.13 | $4,466.84 | $6,165.95 |
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 $3,235.94 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,235.94 | $4,570.88 | $5,623.41 |
Lucent Health Setting Professional Modifier None Typical Low $29,512.09 Median $29,512.09 Typical High $31,622.78 | Professional | None | $29,512.09 | $29,512.09 | $31,622.78 |
Moda Health Setting Facility Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,715.35 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,981.07 Typical High $4,677.35 | Professional | None | $3,715.35 | $3,981.07 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $512.86 Typical High $3,467.37 | Professional | None | $58.88 | $512.86 | $3,467.37 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,630.27 | $2,630.27 | $2,754.23 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $2,691.53 Typical High $251,188.64 | Facility | None | $851.14 | $2,691.53 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,235.94 | $4,570.88 | $5,623.41 |
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 $3,090.30 Median $3,890.45 Typical High $5,623.41 | Professional | None | $3,090.30 | $3,890.45 | $5,623.41 |
Wellpoint Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $1,862.09 Median $1,995.26 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,862.09 | $1,995.26 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $794.33 Typical High $912.01 | Professional | 53 · Discontinued | $741.31 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,019.95 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,754.23 | $3,019.95 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $602.56 Typical High $691.83 | Professional | 55 · Aftercare only | $549.54 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $398.11 Typical High $457.09 | Professional | 56 · Pre-op care only | $371.54 | $398.11 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,818.38 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,818.38 | $3,235.94 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,862.09 Median $1,995.26 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,862.09 | $1,995.26 | $2,089.30 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $794.33 Typical High $851.14 | Professional | 53 · Discontinued | $741.31 | $794.33 | $851.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,019.95 Typical High $3,162.28 | Professional | 54 · Surgery only | $2,754.23 | $3,019.95 | $3,162.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $602.56 Typical High $630.96 | Professional | 55 · Aftercare only | $549.54 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $398.11 Typical High $416.87 | Professional | 56 · Pre-op care only | $371.54 | $398.11 | $416.87 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,818.38 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,818.38 | $2,951.21 |
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
$603
AK $13,183TX $603
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.