How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,622 to $8,128Professionalmedian $380 · 10th to 90th $58 to $1,096
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 $457.09 Median $489.78 Typical High $1,698.24 | Professional | None | $457.09 | $489.78 | $1,698.24 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $588.84 | Professional | None | $436.52 | $436.52 | $588.84 |
BCBS Texas Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $8,317.64 | Facility | None | $1,698.24 | $3,235.94 | $8,317.64 |
BCBS Texas Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $812.83 | Professional | None | $446.68 | $575.44 | $812.83 |
Christus Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $2,187.76 Typical High $3,311.31 | Facility | None | $870.96 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $851.14 | Professional | None | $501.19 | $575.44 | $851.14 |
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 $3,890.45 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,890.45 | $4,168.69 | $4,168.69 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $1,995.26 Typical High $6,760.83 | Facility | None | $537.03 | $1,995.26 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $724.44 | Professional | None | $457.09 | $489.78 | $724.44 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $309.03 Typical High $436.52 | Professional | None | $53.70 | $309.03 | $436.52 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $6,760.83 | Facility | None | $707.95 | $2,290.87 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $851.14 | Professional | None | $501.19 | $575.44 | $851.14 |
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 $389.05 Median $524.81 Typical High $794.33 | Professional | None | $389.05 | $524.81 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $229.09 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $398.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $245.47 | $281.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $97.72 | $112.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $371.54 | $426.58 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $74.13 | $85.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $56.23 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $346.74 | $398.11 |
Where Texas sits
The same service costs 10.0 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
$437
OK $3,631UT $363
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.