How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,096 to $5,495Professionalmedian $195 · 10th to 90th $29 to $1,950
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 $645.65 Median $2,630.27 Typical High $6,918.31 | Facility | None | $645.65 | $2,630.27 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $281.84 | Professional | None | $181.97 | $208.93 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
BCBS Texas Setting Facility Modifier None Typical Low $1,380.38 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,380.38 | $2,570.40 | $5,128.61 |
BCBS Texas Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $354.81 | Professional | None | $177.83 | $234.42 | $354.81 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $2,818.38 | Facility | None | $602.56 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $338.84 | Professional | None | $190.55 | $239.88 | $338.84 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,949.84 | $2,344.23 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $1,174.90 Typical High $5,128.61 | Facility | None | $204.17 | $1,174.90 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $281.84 | Professional | None | $181.97 | $208.93 | $281.84 |
Molina Setting Professional Modifier None Typical Low $21.88 Median $117.49 Typical High $204.17 | Professional | None | $21.88 | $117.49 | $204.17 |
Providence Setting Facility Modifier None Typical Low $257.04 Median $2,041.74 Typical High $4,466.84 | Facility | None | $257.04 | $2,041.74 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $338.84 | Professional | None | $190.55 | $239.88 | $338.84 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $323.59 | Professional | None | $151.36 | $208.93 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $89.13 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $144.54 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $125.89 | $144.54 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $89.13 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $47.86 | Professional | 53 · Discontinued | $36.31 | $41.69 | $47.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $177.83 | Professional | 54 · Surgery only | $134.90 | $154.88 | $177.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $35.48 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $23.99 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $144.54 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $125.89 | $144.54 | $165.96 |
Where Texas sits
The same service costs 5.9 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· 49th of 51
$219
OK $1,175UT $200
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.