How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,905 to $9,550Professionalmedian $135 · 10th to 90th $17 to $1,023
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 $1,000.00 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $2,398.83 | Professional | None | $812.83 | $891.25 | $2,398.83 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,365.16 Typical High $10,232.93 | Facility | None | $2,398.83 | $4,365.16 | $10,232.93 |
BCBS Texas Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,288.25 | Professional | None | $758.58 | $954.99 | $1,288.25 |
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 $870.96 Median $3,467.37 Typical High $4,897.79 | Facility | None | $870.96 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,318.26 | Professional | None | $812.83 | $933.25 | $1,318.26 |
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 $6,025.60 Median $6,025.60 Typical High $6,456.54 | Professional | None | $6,025.60 | $6,025.60 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $758.58 Median $2,511.89 Typical High $6,918.31 | Facility | None | $758.58 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,174.90 | Professional | None | $812.83 | $891.25 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $107.15 Typical High $676.08 | Professional | None | $14.79 | $107.15 | $676.08 |
Providence Setting Facility Modifier None Typical Low $851.14 Median $3,548.13 Typical High $7,244.36 | Facility | None | $851.14 | $3,548.13 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,318.26 | Professional | None | $812.83 | $933.25 | $1,318.26 |
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 $616.60 Median $831.76 Typical High $1,258.93 | Professional | None | $616.60 | $831.76 | $1,258.93 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $407.38 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $660.69 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $446.68 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $177.83 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $616.60 | $660.69 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $97.72 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $676.08 |
Where Texas sits
The same service costs 7.4 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.
Texas· 51st of 51
$525
OK $3,890TX $525
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.