How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,622 to $8,511Professionalmedian $331 · 10th to 90th $52 to $3,020
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 $398.11 Median $436.52 Typical High $1,513.56 | Professional | None | $398.11 | $436.52 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
BCBS Texas Setting Facility Modifier None Typical Low $1,819.70 Median $4,365.16 Typical High $8,912.51 | Facility | None | $1,819.70 | $4,365.16 | $8,912.51 |
BCBS Texas Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $501.19 | Professional | None | $380.19 | $416.87 | $501.19 |
Christus Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,073.80 | Facility | None | $4,073.80 | $4,073.80 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,890.45 Typical High $5,495.41 | Facility | None | $870.96 | $3,890.45 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $741.31 | Professional | None | $446.68 | $501.19 | $741.31 |
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 $3,162.28 Median $3,162.28 Typical High $3,388.44 | Professional | None | $3,162.28 | $3,162.28 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $2,511.89 Typical High $6,760.83 | Facility | None | $467.74 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $660.69 | Professional | None | $398.11 | $426.58 | $660.69 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $281.84 Typical High $407.38 | Professional | None | $48.98 | $281.84 | $407.38 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $3,890.45 Typical High $7,244.36 | Facility | None | $691.83 | $3,890.45 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $758.58 | Professional | None | $446.68 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,232.93 | Facility | None | $1,698.24 | $4,570.88 | $10,232.93 |
United Setting Professional Modifier None Typical Low $338.84 Median $457.09 Typical High $691.83 | Professional | None | $338.84 | $457.09 | $691.83 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $199.53 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $323.59 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $346.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $213.80 | $245.47 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $85.11 | $100.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $323.59 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $50.12 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $50.12 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $346.74 |
Where Texas sits
The same service costs 9.8 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
$380
OK $3,236UT $331
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.