How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,202 to $8,511Professionalmedian $457 · 10th to 90th $30 to $1,047
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 $3,311.31 Typical High $8,709.64 | Facility | None | $1,000.00 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,479.11 | Professional | None | $870.96 | $954.99 | $1,479.11 |
BCBS Texas Setting Facility Modifier None Typical Low $3,019.95 Median $5,754.40 Typical High $10,964.78 | Facility | None | $3,019.95 | $5,754.40 | $10,964.78 |
BCBS Texas Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,258.93 | Professional | None | $758.58 | $954.99 | $1,258.93 |
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 $691.83 Median $2,238.72 Typical High $2,884.03 | Facility | None | $691.83 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,096.48 | Professional | None | $776.25 | $812.83 | $1,096.48 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,456.54 | Professional | None | $6,165.95 | $6,165.95 | $6,456.54 |
Moda Health Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $6,025.60 | Facility | None | $741.31 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,230.27 | Professional | None | $870.96 | $954.99 | $1,230.27 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $134.90 Typical High $707.95 | Professional | None | $25.70 | $134.90 | $707.95 |
Providence Setting Facility Modifier None Typical Low $741.31 Median $2,238.72 Typical High $6,165.95 | Facility | None | $741.31 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $776.25 Median $812.83 Typical High $1,096.48 | Professional | None | $776.25 | $812.83 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,122.02 | Professional | None | $588.84 | $776.25 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | None | $741.31 | $758.58 | $758.58 |
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 $436.52 Median $467.74 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $467.74 Typical High $575.44 | Professional | 52 · Reduced service | $436.52 | $467.74 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $173.78 | $190.55 | $229.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $707.95 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $87.10 | $95.50 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $794.33 |
Where Texas sits
The same service costs 8.3 times more in Wyoming 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
$537
WY $4,074UT $490
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.