How much rates vary
Facilitymedian $1,995 · 10th to 90th $977 to $5,495Professionalmedian $251 · 10th to 90th $40 to $2,089
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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $416.87 | Professional | None | $269.15 | $288.40 | $416.87 |
BCBS Texas Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $4,677.35 | Facility | None | $1,071.52 | $1,778.28 | $4,677.35 |
BCBS Texas Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $489.78 | Professional | None | $213.80 | $257.04 | $489.78 |
Christus Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $2,884.03 | Facility | None | $758.58 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $478.63 | Professional | None | $288.40 | $323.59 | $478.63 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,187.76 | Professional | None | $2,089.30 | $2,089.30 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $338.84 Median $1,995.26 Typical High $7,585.78 | Facility | None | $338.84 | $1,995.26 | $7,585.78 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $288.40 Typical High $416.87 | Professional | None | $269.15 | $288.40 | $416.87 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $199.53 Typical High $281.84 | Professional | None | $37.15 | $199.53 | $281.84 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $2,884.03 | Facility | None | $407.38 | $2,137.96 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $478.63 | Professional | None | $288.40 | $331.13 | $478.63 |
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 $223.87 Median $295.12 Typical High $446.68 | Professional | None | $223.87 | $295.12 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
13 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 $131.83 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $131.83 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $67.61 | Professional | 53 · Discontinued | $52.48 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $234.42 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | 59 · Distinct service | $295.12 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $144.54 Typical High $169.82 | Professional | 52 · Reduced service | $131.83 | $144.54 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $58.88 Typical High $67.61 | Professional | 53 · Discontinued | $52.48 | $58.88 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $218.78 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $50.12 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $33.88 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $33.88 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $234.42 |
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· 49th of 51
$282
OK $1,479UT $245
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.