How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,349 to $7,413Professionalmedian $490 · 10th to 90th $62 to $1,175
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 $2,691.53 | Professional | None | $660.69 | $707.95 | $2,691.53 |
BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,691.53 Typical High $7,079.46 | Facility | None | $1,380.38 | $2,691.53 | $7,079.46 |
BCBS Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $812.83 | Professional | None | $630.96 | $691.83 | $812.83 |
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 $691.83 Median $2,187.76 Typical High $2,884.03 | Facility | None | $691.83 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,230.27 | Professional | None | $724.44 | $831.76 | $1,230.27 |
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 $5,248.07 Median $5,248.07 Typical High $5,495.41 | Professional | None | $5,248.07 | $5,248.07 | $5,495.41 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $2,454.71 Typical High $6,025.60 | Facility | None | $676.08 | $2,454.71 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $707.95 Typical High $1,000.00 | Professional | None | $660.69 | $707.95 | $1,000.00 |
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 $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 $724.44 Median $831.76 Typical High $1,230.27 | Professional | None | $724.44 | $831.76 | $1,230.27 |
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 $562.34 Median $776.25 Typical High $1,148.15 | Professional | None | $562.34 | $776.25 | $1,148.15 |
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 $162.18 | Professional | 53 · Discontinued | $131.83 | $141.25 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $537.03 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $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 $162.18 | Professional | 53 · Discontinued | $131.83 | $141.25 | $162.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 54 · Surgery only | $489.78 | $537.03 | $616.60 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $107.15 | $123.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $70.79 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $70.79 | $81.28 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $501.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $457.09 | $501.19 | $575.44 |
Where Texas sits
The same service costs 7.2 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
$562
OK $3,802UT $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.