How much rates vary
Facilitymedian $1,862 · 10th to 90th $813 to $4,169Professionalmedian $525 · 10th to 90th $27 to $912
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 $2,630.27 Typical High $6,918.31 | Facility | None | $707.95 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,071.52 | Professional | None | $457.09 | $660.69 | $1,071.52 |
BCBS Texas Setting Facility Modifier None Typical Low $912.01 Median $1,862.09 Typical High $4,365.16 | Facility | None | $912.01 | $1,862.09 | $4,365.16 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,174.90 | Professional | None | $562.34 | $741.31 | $1,174.90 |
Christus Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,445.44 Typical High $2,187.76 | Facility | None | $602.56 | $1,445.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,047.13 | Professional | None | $588.84 | $776.25 | $1,047.13 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,760.83 | Professional | None | $5,623.41 | $5,623.41 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $588.84 Median $1,202.26 Typical High $4,570.88 | Facility | None | $588.84 | $1,202.26 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $1,071.52 | Professional | None | $457.09 | $676.08 | $1,071.52 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $120.23 Typical High $691.83 | Professional | None | $19.95 | $120.23 | $691.83 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $1,479.11 Typical High $4,466.84 | Facility | None | $588.84 | $1,479.11 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,047.13 | Professional | None | $588.84 | $776.25 | $1,047.13 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $977.24 | Professional | None | $501.19 | $707.95 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $229.09 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $229.09 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $91.20 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $346.74 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $323.59 | $416.87 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $229.09 | $295.12 | $363.08 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $91.20 | $117.49 | $144.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $346.74 | $446.68 | $549.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $69.18 | $89.13 | $109.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $72.44 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $323.59 | $416.87 | $512.86 |
Where Texas sits
The same service costs 4.2 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
$589
AK $2,455TX $589
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.