How much rates vary
Facilitymedian $1,660 · 10th to 90th $776 to $4,898Professionalmedian $245 · 10th to 90th $36 to $407
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $363.08 | Professional | None | $154.88 | $288.40 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
BCBS Texas Setting Facility Modifier None Typical Low $851.14 Median $1,621.81 Typical High $3,801.89 | Facility | None | $851.14 | $1,621.81 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $436.52 | Professional | None | $169.82 | $295.12 | $436.52 |
Christus Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,071.52 Typical High $1,659.59 | Facility | None | $457.09 | $1,071.52 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $467.74 | Professional | None | $194.98 | $302.00 | $467.74 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,884.03 | $2,951.21 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $199.53 Median $1,000.00 Typical High $5,128.61 | Facility | None | $199.53 | $1,000.00 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $363.08 | Professional | None | $154.88 | $288.40 | $363.08 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $213.80 Typical High $331.13 | Professional | None | $33.11 | $213.80 | $331.13 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $3,801.89 | Facility | None | $323.59 | $1,096.48 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $467.74 | Professional | None | $194.98 | $302.00 | $467.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $457.09 | Professional | None | $154.88 | $269.15 | $457.09 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $77.62 Median $144.54 Typical High $173.78 | Professional | 52 · Reduced service | $77.62 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $30.90 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $114.82 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $23.44 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $15.49 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $199.53 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $107.15 | $199.53 | $245.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $144.54 Typical High $173.78 | Professional | 52 · Reduced service | $77.62 | $144.54 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $30.90 | $57.54 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $114.82 | $213.80 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $23.44 | $42.66 | $51.29 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $15.49 | $28.84 | $34.67 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $107.15 | $199.53 | $239.88 |
Where Texas sits
The same service costs 6.4 times more in Oklahoma than in North Dakota. 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.
Physician feeFacility fee
OK $5,125ND $804
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.