How much rates vary
Facilitymedian $6,457 · 10th to 90th $2,344 to $13,183Professionalmedian $234 · 10th to 90th $35 to $1,318
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 $1,096.48 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,096.48 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,071.52 Typical High $1,412.54 | Professional | None | $977.24 | $1,071.52 | $1,412.54 |
BCBS Texas Setting Facility Modifier None Typical Low $3,981.07 Median $7,079.46 Typical High $15,848.93 | Facility | None | $3,981.07 | $7,079.46 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,348.96 | $1,862.09 |
Christus Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $5,754.40 Typical High $8,317.64 | Facility | None | $870.96 | $5,754.40 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,318.26 | $1,905.46 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,332.54 | Professional | None | $9,120.11 | $9,120.11 | $9,332.54 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $2,570.40 Typical High $6,760.83 | Facility | None | $977.24 | $2,570.40 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,380.38 | Professional | None | $977.24 | $1,096.48 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $186.21 Typical High $977.24 | Professional | None | $31.62 | $186.21 | $977.24 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $5,754.40 Typical High $8,511.38 | Facility | None | $933.25 | $5,754.40 | $8,511.38 |
Providence Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,318.26 | $1,949.84 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,309.57 | $15,135.61 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,905.46 | Professional | None | $912.01 | $1,202.26 | $1,905.46 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $489.78 Median $537.03 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $870.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $537.03 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $537.03 | $602.56 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $213.80 | $245.47 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $724.44 | $812.83 | $912.01 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $162.18 Typical High $181.97 | Professional | 55 · Aftercare only | $144.54 | $162.18 | $181.97 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $676.08 | $758.58 | $851.14 |
Where Texas sits
The same service costs 8.3 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
$575
AK $4,786TX $575
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.