How much rates vary
Facilitymedian $224 · 10th to 90th $107 to $2,291Professionalmedian $204 · 10th to 90th $11 to $417
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $380.19 | Professional | None | $223.87 | $257.04 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
BCBS Texas Setting Facility Modifier None Typical Low $107.15 Median $162.18 Typical High $954.99 | Facility | None | $107.15 | $162.18 | $954.99 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $489.78 | Professional | None | $251.19 | $331.13 | $489.78 |
Christus Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $162.18 Typical High $239.88 | Facility | None | $66.07 | $162.18 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $407.38 | Professional | None | $257.04 | $323.59 | $407.38 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,187.76 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $707.95 Typical High $4,168.69 | Facility | None | $269.15 | $707.95 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $407.38 | Professional | None | $223.87 | $263.03 | $407.38 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $57.54 Typical High $338.84 | Professional | None | $9.55 | $57.54 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,258.93 | Professional | None | $977.24 | $1,047.13 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $181.97 Typical High $371.54 | Facility | None | $66.07 | $181.97 | $371.54 |
Providence Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $407.38 | Professional | None | $257.04 | $323.59 | $407.38 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | None | $199.53 | $263.03 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $112.20 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $112.20 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $44.67 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $165.96 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $47.86 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $223.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $112.20 | $134.90 | $154.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $44.67 | $53.70 | $61.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $165.96 | $199.53 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $33.11 | $39.81 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $30.90 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $154.88 | $186.21 | $218.78 |
Where Texas sits
The same service costs 5.4 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
$204
AK $1,096TX $204
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.