How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,259 to $6,761Professionalmedian $398 · 10th to 90th $59 to $933
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 $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $891.25 | Professional | None | $537.03 | $588.84 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $524.81 Typical High $524.81 | Professional | None | $263.03 | $524.81 | $524.81 |
BCBS Texas Setting Facility Modifier None Typical Low $1,348.96 Median $2,630.27 Typical High $6,760.83 | Facility | None | $1,348.96 | $2,630.27 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $954.99 | Professional | None | $537.03 | $676.08 | $954.99 |
Christus Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,801.89 | Facility | None | $954.99 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $891.25 | Professional | None | $549.54 | $645.65 | $891.25 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Professional | None | $4,265.80 | $4,265.80 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $812.83 Median $4,168.69 Typical High $12,882.50 | Facility | None | $812.83 | $4,168.69 | $12,882.50 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $870.96 | Professional | None | $537.03 | $588.84 | $870.96 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $512.86 | Professional | None | $54.95 | $100.00 | $512.86 |
Providence Setting Facility Modifier None Typical Low $812.83 Median $2,344.23 Typical High $7,585.78 | Facility | None | $812.83 | $2,344.23 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $891.25 | Professional | None | $549.54 | $660.69 | $891.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $870.96 | Professional | None | $426.58 | $575.44 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $269.15 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $295.12 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $295.12 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $117.49 Typical High $138.04 | Professional | 53 · Discontinued | $107.15 | $117.49 | $138.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $446.68 Typical High $512.86 | Professional | 54 · Surgery only | $398.11 | $446.68 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $89.13 Typical High $102.33 | Professional | 55 · Aftercare only | $79.43 | $89.13 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $58.88 Typical High $69.18 | Professional | 56 · Pre-op care only | $53.70 | $58.88 | $69.18 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $416.87 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $371.54 | $416.87 | $478.63 |
Where Texas sits
The same service costs 3.6 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $6,446MT $1,806
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.