How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,820 to $10,233Professionalmedian $468 · 10th to 90th $60 to $832
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 $660.69 Median $707.95 Typical High $2,454.71 | Professional | None | $660.69 | $707.95 | $2,454.71 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $4,265.80 Typical High $10,964.78 | Facility | None | $2,041.74 | $4,265.80 | $10,964.78 |
BCBS Texas Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,318.26 | Professional | None | $575.44 | $758.58 | $1,318.26 |
Christus Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,162.28 Typical High $4,466.84 | Facility | None | $691.83 | $3,162.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,258.93 | Professional | None | $741.31 | $831.76 | $1,258.93 |
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 $6,918.31 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,918.31 | $6,918.31 | $6,918.31 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $2,398.83 Typical High $6,025.60 | Facility | None | $676.08 | $2,398.83 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,122.02 | Professional | None | $660.69 | $707.95 | $1,122.02 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $630.96 | Professional | None | $56.23 | $117.49 | $630.96 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $3,235.94 Typical High $6,606.93 | Facility | None | $707.95 | $3,235.94 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,258.93 | Professional | None | $741.31 | $831.76 | $1,258.93 |
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 $562.34 Median $758.58 Typical High $1,174.90 | Professional | None | $562.34 | $758.58 | $1,174.90 |
Wellpoint Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $331.13 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $354.81 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $354.81 | $407.38 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $141.25 | $165.96 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $501.19 | $537.03 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $83.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $575.44 |
Where Texas sits
The same service costs 8.7 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
$550
OK $4,365UT $501
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.