How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,413 to $9,333Professionalmedian $617 · 10th to 90th $60 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 $1,023.29 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,023.29 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,348.96 | Professional | None | $933.25 | $1,000.00 | $1,348.96 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $9,772.37 | Facility | None | $2,630.27 | $4,786.30 | $9,772.37 |
BCBS Texas Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,949.84 | Professional | None | $870.96 | $1,122.02 | $1,949.84 |
Christus Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,905.46 Typical High $3,801.89 | Facility | None | $954.99 | $1,905.46 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,412.54 | Professional | None | $794.33 | $1,071.52 | $1,412.54 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
Moda Health Setting Facility Modifier None Typical Low $891.25 Median $2,570.40 Typical High $7,943.28 | Facility | None | $891.25 | $2,570.40 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,174.90 | Professional | None | $933.25 | $1,000.00 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $151.36 Typical High $831.76 | Professional | None | $54.95 | $151.36 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $891.25 | Professional | None | $851.14 | $851.14 | $891.25 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $2,041.74 Typical High $7,585.78 | Facility | None | $933.25 | $2,041.74 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,412.54 | Professional | None | $794.33 | $1,071.52 | $1,412.54 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,412.54 | Professional | None | $776.25 | $977.24 | $1,412.54 |
Wellpoint Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $467.74 Median $489.78 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $186.21 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $870.96 | Professional | 54 · Surgery only | $691.83 | $741.31 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $489.78 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $489.78 | $524.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $199.53 | $208.93 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $741.31 | $794.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $158.49 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $158.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $104.71 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $741.31 |
Where Texas sits
The same service costs 6.2 times more in Alaska 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
$617
AK $3,802TX $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.