How much rates vary
Facilitymedian $4,467 · 10th to 90th $2,188 to $11,482Professionalmedian $398 · 10th to 90th $60 to $741
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 $3,715.35 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $1,862.09 | Professional | None | $562.34 | $616.60 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,589.25 | Facility | None | $2,398.83 | $4,897.79 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $954.99 | Professional | None | $549.54 | $691.83 | $954.99 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $3,467.37 Typical High $4,897.79 | Facility | None | $870.96 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,000.00 | Professional | None | $616.60 | $741.31 | $1,000.00 |
Health Smart Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
Lucent Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $2,511.89 Typical High $6,918.31 | Facility | None | $616.60 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $851.14 | Professional | None | $562.34 | $616.60 | $851.14 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $95.50 Typical High $512.86 | Professional | None | $54.95 | $95.50 | $512.86 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $3,548.13 Typical High $7,244.36 | Facility | None | $794.33 | $3,548.13 | $7,244.36 |
Providence Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,000.00 | Professional | None | $616.60 | $741.31 | $1,000.00 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,309.57 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,309.57 | $14,791.08 |
United Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $933.25 | Professional | None | $457.09 | $616.60 | $933.25 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $281.84 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $457.09 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $478.63 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $302.00 Typical High $338.84 | Professional | 52 · Reduced service | $281.84 | $302.00 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $123.03 | $134.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $457.09 Typical High $512.86 | Professional | 54 · Surgery only | $426.58 | $457.09 | $512.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $91.20 Typical High $102.33 | Professional | 55 · Aftercare only | $85.11 | $91.20 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $67.61 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $67.61 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $426.58 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $398.11 | $426.58 | $478.63 |
Where Texas sits
The same service costs 8.1 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
$457
OK $3,467UT $427
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.