How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,202 to $6,918Professionalmedian $263 · 10th to 90th $40 to $537
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $1,148.15 | Professional | None | $338.84 | $371.54 | $1,148.15 |
BCBS Texas Setting Facility Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $6,456.54 | Facility | None | $1,412.54 | $2,630.27 | $6,456.54 |
BCBS Texas Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,122.02 | Professional | None | $338.84 | $436.52 | $1,122.02 |
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 $977.24 Median $2,238.72 Typical High $3,801.89 | Facility | None | $977.24 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $616.60 | Professional | None | $371.54 | $416.87 | $616.60 |
Lucent Health Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $2,570.40 Typical High $8,317.64 | Facility | None | $436.52 | $2,570.40 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $537.03 | Professional | None | $338.84 | $371.54 | $537.03 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $204.17 Typical High $331.13 | Professional | None | $37.15 | $204.17 | $331.13 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $2,344.23 Typical High $7,762.47 | Facility | None | $724.44 | $2,344.23 | $7,762.47 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $630.96 | Professional | None | $371.54 | $426.58 | $630.96 |
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 $288.40 Median $389.05 Typical High $588.84 | Professional | None | $288.40 | $389.05 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
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 $169.82 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $257.04 | $302.00 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 59 · Distinct service | $323.59 | $323.59 | $323.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | 52 · Reduced service | $169.82 | $186.21 | $218.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $74.13 Typical High $87.10 | Professional | 53 · Discontinued | $67.61 | $74.13 | $87.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $281.84 | $323.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $56.23 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $56.23 | $64.57 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $37.15 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.88 | $37.15 | $43.65 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $263.03 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $263.03 | $302.00 |
Where Texas sits
The same service costs 7.1 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
$316
OK $1,950UT $275
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.