How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,047 to $8,318Professionalmedian $525 · 10th to 90th $62 to $1,288
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $2,137.96 | Professional | None | $691.83 | $741.31 | $2,137.96 |
BCBS Texas Setting Facility Modifier None Typical Low $1,047.13 Median $2,691.53 Typical High $7,585.78 | Facility | None | $1,047.13 | $2,691.53 | $7,585.78 |
BCBS Texas Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,584.89 | Professional | None | $676.08 | $870.96 | $1,584.89 |
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 $707.95 Median $2,187.76 Typical High $2,884.03 | Facility | None | $707.95 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,318.26 | Professional | None | $758.58 | $870.96 | $1,318.26 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,754.40 | Professional | None | $5,623.41 | $5,623.41 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $6,918.31 | Facility | None | $707.95 | $2,570.40 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,230.27 | Professional | None | $691.83 | $741.31 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $123.03 Typical High $676.08 | Professional | None | $56.23 | $123.03 | $676.08 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,238.72 Typical High $6,165.95 | Facility | None | $707.95 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,318.26 | Professional | None | $758.58 | $870.96 | $1,318.26 |
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 $588.84 Median $812.83 Typical High $1,230.27 | Professional | None | $588.84 | $812.83 | $1,230.27 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $346.74 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $371.54 Typical High $426.58 | Professional | 52 · Reduced service | $346.74 | $371.54 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $147.91 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $512.86 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $74.13 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $74.13 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $478.63 | $524.81 | $602.56 |
Where Texas sits
The same service costs 7.9 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· 50th of 51
$603
OK $4,169UT $525
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.