How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,738 to $10,715Professionalmedian $417 · 10th to 90th $60 to $794
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,862.09 | Professional | None | $630.96 | $707.95 | $1,862.09 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,786.30 Typical High $12,589.25 | Facility | None | $2,398.83 | $4,786.30 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,258.93 | Professional | None | $602.56 | $758.58 | $1,258.93 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $3,467.37 Typical High $4,897.79 | Facility | None | $602.56 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,023.29 | Professional | None | $630.96 | $741.31 | $1,023.29 |
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 $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $1,905.46 Typical High $5,495.41 | Facility | None | $630.96 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $933.25 | Professional | None | $645.65 | $724.44 | $933.25 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $562.34 | Professional | None | $54.95 | $107.15 | $562.34 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $3,388.44 Typical High $4,897.79 | Facility | None | $602.56 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,023.29 | Professional | None | $630.96 | $741.31 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $977.24 | Professional | None | $489.78 | $660.69 | $977.24 |
Wellpoint Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $323.59 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $354.81 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $354.81 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $128.82 | $141.25 | $154.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $524.81 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $70.79 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $70.79 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $537.03 |
Where Texas sits
The same service costs 8.1 times more in Oklahoma than in Utah. 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· 50th of 51
$490
OK $3,548UT $437
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.