How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,202 to $8,318Professionalmedian $631 · 10th to 90th $65 to $5,129
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 $870.96 Median $3,715.35 Typical High $9,120.11 | Facility | None | $870.96 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,000.00 | Professional | None | $707.95 | $794.33 | $1,000.00 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $4,570.88 Typical High $10,000.00 | Facility | None | $2,630.27 | $4,570.88 | $10,000.00 |
BCBS Texas Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,174.90 | Professional | None | $676.08 | $870.96 | $1,174.90 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $2,691.53 | Facility | None | $758.58 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,023.29 | Professional | None | $724.44 | $870.96 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $6,760.83 | Professional | None | $5,128.61 | $5,128.61 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $1,819.70 Typical High $6,918.31 | Facility | None | $707.95 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,148.15 | Professional | None | $707.95 | $794.33 | $1,148.15 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $144.54 Typical High $776.25 | Professional | None | $56.23 | $144.54 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,630.27 | $2,754.23 | $2,951.21 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $1,995.26 Typical High $2,691.53 | Facility | None | $707.95 | $1,995.26 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,023.29 | Professional | None | $724.44 | $851.14 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $501.19 Median $691.83 Typical High $1,096.48 | Professional | None | $501.19 | $691.83 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $354.81 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $354.81 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $645.65 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $389.05 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $154.88 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $154.88 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $588.84 Typical High $660.69 | Professional | 54 · Surgery only | $537.03 | $588.84 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $117.49 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $117.49 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $77.62 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $77.62 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $549.54 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $501.19 | $549.54 | $616.60 |
Where Texas sits
The same service costs 6.8 times more in Oklahoma than in Kentucky. 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
$708
OK $4,169KY $617
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.