How much rates vary
Facilitymedian $2,291 · 10th to 90th $891 to $8,710Professionalmedian $562 · 10th to 90th $37 to $1,000
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 $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $2,951.21 | Professional | None | $794.33 | $851.14 | $2,951.21 |
BCBS Texas Setting Facility Modifier None Typical Low $851.14 Median $1,621.81 Typical High $6,760.83 | Facility | None | $851.14 | $1,621.81 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,548.82 | Professional | None | $758.58 | $954.99 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,445.44 | Professional | None | $851.14 | $954.99 | $1,445.44 |
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 $794.33 Median $2,511.89 Typical High $7,943.28 | Facility | None | $794.33 | $2,511.89 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,122.02 | Professional | None | $794.33 | $831.76 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $125.89 Typical High $741.31 | Professional | None | $28.18 | $125.89 | $741.31 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $251,188.64 | Facility | None | $724.44 | $1,380.38 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $1,445.44 | Professional | None | $851.14 | $954.99 | $1,445.44 |
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 $645.65 Median $891.25 Typical High $1,380.38 | Professional | None | $645.65 | $891.25 | $1,380.38 |
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 $398.11 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $676.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $398.11 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $158.49 | $162.18 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $616.60 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $79.43 | $81.28 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $676.08 |
Where Texas sits
The same service costs 6.2 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
$603
OK $3,631UT $589
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.