How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,905 to $19,953Professionalmedian $525 · 10th to 90th $79 to $1,259
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 $1,096.48 Median $4,073.80 Typical High $10,000.00 | Facility | None | $1,096.48 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $2,344.23 | Professional | None | $758.58 | $812.83 | $2,344.23 |
BCBS Texas Setting Facility Modifier None Typical Low $7,943.28 Median $14,125.38 Typical High $31,622.78 | Facility | None | $7,943.28 | $14,125.38 | $31,622.78 |
BCBS Texas Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $2,511.89 | Professional | None | $741.31 | $954.99 | $2,511.89 |
Christus Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $8,317.64 | Facility | None | $758.58 | $5,888.44 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,380.38 | Professional | None | $812.83 | $933.25 | $1,380.38 |
Lucent Health Setting Professional Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,888.44 | $6,165.95 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $794.33 Median $3,981.07 Typical High $12,302.69 | Facility | None | $794.33 | $3,981.07 | $12,302.69 |
Moda Health Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,174.90 | Professional | None | $758.58 | $812.83 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $72.44 Median $123.03 Typical High $691.83 | Professional | None | $72.44 | $123.03 | $691.83 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $5,754.40 Typical High $8,317.64 | Facility | None | $707.95 | $5,754.40 | $8,317.64 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,380.38 | Professional | None | $794.33 | $912.01 | $1,380.38 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,309.57 | $15,848.93 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,318.26 | Professional | None | $645.65 | $870.96 | $1,318.26 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $371.54 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $371.54 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $562.34 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $407.38 Typical High $478.63 | Professional | 52 · Reduced service | $371.54 | $407.38 | $478.63 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $162.18 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $162.18 | $190.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $707.95 | Professional | 54 · Surgery only | $549.54 | $616.60 | $707.95 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $141.25 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $81.28 | $95.50 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $660.69 |
Where Texas sits
The same service costs 11.0 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· 50th of 51
$575
OK $5,888UT $537
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.