How much rates vary
Facilitymedian $1,230 · 10th to 90th $295 to $6,166Professionalmedian $407 · 10th to 90th $62 to $912
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 $707.95 Median $3,235.94 Typical High $8,511.38 | Facility | None | $707.95 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $870.96 | Professional | None | $323.59 | $512.86 | $870.96 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $616.60 | Professional | None | $295.12 | $295.12 | $616.60 |
BCBS Texas Setting Facility Modifier None Typical Low $251.19 Median $446.68 Typical High $2,398.83 | Facility | None | $251.19 | $446.68 | $2,398.83 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $912.01 | Professional | None | $309.03 | $457.09 | $912.01 |
Christus Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $2,691.53 | Facility | None | $257.04 | $363.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $1,000.00 | Professional | None | $354.81 | $512.86 | $1,000.00 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,570.88 | $4,570.88 | $4,570.88 |
Moda Health Setting Facility Modifier None Typical Low $478.63 Median $2,818.38 Typical High $7,413.10 | Facility | None | $478.63 | $2,818.38 | $7,413.10 |
Moda Health Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $794.33 | Professional | None | $323.59 | $512.86 | $794.33 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $489.78 | Professional | None | $54.95 | $91.20 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $676.08 Typical High $1,148.15 | Professional | None | $363.08 | $676.08 | $1,148.15 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $6,165.95 | Facility | None | $295.12 | $562.34 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $512.86 Typical High $1,000.00 | Professional | None | $354.81 | $512.86 | $1,000.00 |
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 $346.74 Median $602.56 Typical High $933.25 | Professional | None | $346.74 | $602.56 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
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 $162.18 Median $251.19 Typical High $302.00 | Professional | 52 · Reduced service | $162.18 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $64.57 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $380.19 Typical High $446.68 | Professional | 54 · Surgery only | $245.47 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $75.86 Typical High $89.13 | Professional | 55 · Aftercare only | $48.98 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $32.36 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $354.81 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $229.09 | $354.81 | $416.87 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $162.18 | $245.47 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $64.57 | $97.72 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $363.08 Typical High $426.58 | Professional | 54 · Surgery only | $245.47 | $363.08 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $72.44 Typical High $85.11 | Professional | 55 · Aftercare only | $48.98 | $72.44 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $32.36 | $48.98 | $57.54 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $338.84 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $229.09 | $338.84 | $398.11 |
Where Texas sits
The same service costs 4.3 times more in Wisconsin 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
$437
WI $1,862TX $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.