How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,549 to $9,120Professionalmedian $813 · 10th to 90th $537 to $6,026
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 $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,445.44 | Professional | None | $512.86 | $549.54 | $1,445.44 |
BCBS Texas Setting Facility Modifier None Typical Low $3,019.95 Median $5,370.32 Typical High $11,481.54 | Facility | None | $3,019.95 | $5,370.32 | $11,481.54 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $870.96 Median $2,137.96 Typical High $3,311.31 | Facility | None | $870.96 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $977.24 | Professional | None | $575.44 | $645.65 | $977.24 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $6,025.60 Typical High $6,025.60 | Professional | None | $4,677.35 | $6,025.60 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $3,235.94 Typical High $8,511.38 | Facility | None | $707.95 | $3,235.94 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $691.83 | Professional | None | $512.86 | $549.54 | $691.83 |
Molina Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $676.08 | Professional | None | $95.50 | $107.15 | $676.08 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $6,760.83 | Facility | None | $812.83 | $2,290.87 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $954.99 | Professional | None | $575.44 | $645.65 | $954.99 |
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 $575.44 Median $831.76 Typical High $1,412.54 | Professional | None | $575.44 | $831.76 | $1,412.54 |
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 $257.04 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $275.42 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $275.42 | $323.59 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $128.82 | Professional | 53 · Discontinued | $102.33 | $109.65 | $128.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $407.38 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $64.57 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $64.57 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $380.19 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $380.19 | $446.68 |
Where Texas sits
The same service costs 7.4 times more in Oklahoma than in New York. 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· 5th of 51
$2,344
OK $3,802NY $513
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.