How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,291 to $11,749Professionalmedian $537 · 10th to 90th $62 to $1,318
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 $1,202.26 Median $4,168.69 Typical High $10,000.00 | Facility | None | $1,202.26 | $4,168.69 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $3,715.35 | Professional | None | $691.83 | $758.58 | $3,715.35 |
Ambetter Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $758.58 |
BCBS Texas Setting Facility Modifier None Typical Low $2,570.40 Median $5,011.87 Typical High $12,882.50 | Facility | None | $2,570.40 | $5,011.87 | $12,882.50 |
BCBS Texas Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,412.54 | Professional | None | $691.83 | $870.96 | $1,412.54 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $3,715.35 Typical High $4,897.79 | Facility | None | $977.24 | $3,715.35 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,318.26 | Professional | None | $776.25 | $870.96 | $1,318.26 |
Lucent Health Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,754.40 | Professional | None | $5,495.41 | $5,495.41 | $5,754.40 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $3,715.35 Typical High $9,120.11 | Facility | None | $812.83 | $3,715.35 | $9,120.11 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,412.54 | Professional | None | $691.83 | $758.58 | $1,412.54 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $120.23 Typical High $676.08 | Professional | None | $54.95 | $120.23 | $676.08 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $3,801.89 Typical High $7,943.28 | Facility | None | $891.25 | $3,801.89 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,318.26 | Professional | None | $776.25 | $870.96 | $1,318.26 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,456.54 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,456.54 | $14,791.08 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,258.93 | Professional | None | $616.60 | $831.76 | $1,258.93 |
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 $346.74 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $346.74 | $380.19 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $138.04 | $151.36 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $562.34 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $112.20 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $87.10 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $524.81 | $602.56 |
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
$617
OK $3,890UT $537
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.