How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,585 to $16,218Professionalmedian $468 · 10th to 90th $78 to $891
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 $891.25 Median $3,715.35 Typical High $9,120.11 | Facility | None | $891.25 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $891.25 | Professional | None | $691.83 | $776.25 | $891.25 |
BCBS Texas Setting Facility Modifier None Typical Low $5,888.44 Median $10,964.78 Typical High $25,118.86 | Facility | None | $5,888.44 | $10,964.78 | $25,118.86 |
BCBS Texas Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,445.44 | Professional | None | $707.95 | $891.25 | $1,445.44 |
Christus Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,715.35 Typical High $5,248.07 | Facility | None | $758.58 | $3,715.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,288.25 | Professional | None | $758.58 | $870.96 | $1,288.25 |
Lucent Health Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Moda Health Setting Facility Modifier None Typical Low $691.83 Median $1,819.70 Typical High $6,918.31 | Facility | None | $691.83 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $977.24 | Professional | None | $691.83 | $776.25 | $977.24 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $645.65 | Professional | None | $74.13 | $120.23 | $645.65 |
Providence Setting Facility Modifier None Typical Low $676.08 Median $3,630.78 Typical High $5,248.07 | Facility | None | $676.08 | $3,630.78 | $5,248.07 |
Providence Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $1,288.25 | Professional | None | $758.58 | $851.14 | $1,288.25 |
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 $588.84 Median $794.33 Typical High $1,202.26 | Professional | None | $588.84 | $794.33 | $1,202.26 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $446.68 | Professional | 52 · Reduced service | $346.74 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $575.44 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $616.60 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $346.74 Median $389.05 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $389.05 | $446.68 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $154.88 | $177.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $575.44 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $131.83 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $89.13 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $616.60 |
Where Texas sits
The same service costs 6.8 times more in Oklahoma than in Texas. 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· 51st of 51
$525
OK $3,548TX $525
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.