How much rates vary
Facilitymedian $1,862 · 10th to 90th $933 to $5,495Professionalmedian $468 · 10th to 90th $62 to $1,122
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 $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $2,398.83 | Professional | None | $630.96 | $691.83 | $2,398.83 |
BCBS Texas Setting Facility Modifier None Typical Low $933.25 Median $1,778.28 Typical High $4,466.84 | Facility | None | $933.25 | $1,778.28 | $4,466.84 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,023.29 | Professional | None | $537.03 | $676.08 | $1,023.29 |
Christus Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,398.83 | Facility | None | $758.58 | $1,318.26 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,174.90 | Professional | None | $707.95 | $794.33 | $1,174.90 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,248.07 | Professional | None | $5,011.87 | $5,011.87 | $5,248.07 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $2,511.89 Typical High $6,918.31 | Facility | None | $676.08 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $954.99 | Professional | None | $630.96 | $691.83 | $954.99 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $112.20 Typical High $616.60 | Professional | None | $56.23 | $112.20 | $616.60 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $1,258.93 Typical High $2,454.71 | Facility | None | $645.65 | $1,258.93 | $2,454.71 |
Providence Setting Professional Modifier None Typical Low $707.95 Median $794.33 Typical High $1,202.26 | Professional | None | $707.95 | $794.33 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,235.94 | $6,606.93 |
United Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,122.02 | Professional | None | $537.03 | $741.31 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
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 $316.23 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $549.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $338.84 | $398.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $138.04 | $158.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $512.86 | $588.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $117.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $79.43 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $549.54 |
Where Texas sits
The same service costs 6.0 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
$525
OK $2,884UT $479
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.