How much rates vary
Facilitymedian $1,148 · 10th to 90th $537 to $8,128Professionalmedian $324 · 10th to 90th $18 to $724
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $831.76 | Professional | None | $537.03 | $602.56 | $831.76 |
Ambetter Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $588.84 | Professional | None | $549.54 | $549.54 | $588.84 |
BCBS Texas Setting Facility Modifier None Typical Low $467.74 Median $870.96 Typical High $3,548.13 | Facility | None | $467.74 | $870.96 | $3,548.13 |
BCBS Texas Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,096.48 | Professional | None | $588.84 | $741.31 | $1,096.48 |
Christus Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $2,754.23 | Facility | None | $758.58 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,071.52 | Professional | None | $602.56 | $724.44 | $1,071.52 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,248.07 | Professional | None | $4,897.79 | $4,897.79 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $602.56 Median $1,905.46 Typical High $8,511.38 | Facility | None | $602.56 | $1,905.46 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $870.96 | Professional | None | $537.03 | $602.56 | $870.96 |
Molina Setting Professional Modifier None Typical Low $16.60 Median $97.72 Typical High $562.34 | Professional | None | $16.60 | $97.72 | $562.34 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,041.74 Typical High $2,754.23 | Facility | None | $630.96 | $2,041.74 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $588.84 Median $724.44 Typical High $1,071.52 | Professional | None | $588.84 | $724.44 | $1,071.52 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,023.29 | Professional | None | $512.86 | $676.08 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $269.15 Median $302.00 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $524.81 | Professional | 54 · Surgery only | $398.11 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $489.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $269.15 | $302.00 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $120.23 Typical High $134.90 | Professional | 53 · Discontinued | $107.15 | $120.23 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $501.19 | Professional | 54 · Surgery only | $398.11 | $446.68 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $81.28 | $89.13 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $53.70 | $60.26 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $467.74 |
Where Texas sits
The same service costs 7.6 times more in Oklahoma 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.
Physician feeFacility fee
OK $11,248TX $1,472
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.