How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,413 to $7,244Professionalmedian $468 · 10th to 90th $30 to $1,072
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 $954.99 Median $2,754.23 Typical High $6,918.31 | Facility | None | $954.99 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,479.11 | Professional | None | $891.25 | $954.99 | $1,479.11 |
BCBS Texas Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $7,244.36 | Facility | None | $1,513.56 | $3,235.94 | $7,244.36 |
BCBS Texas Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,258.93 | Professional | None | $776.25 | $977.24 | $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 $602.56 Median $2,137.96 Typical High $2,818.38 | Facility | None | $602.56 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,122.02 | Professional | None | $794.33 | $812.83 | $1,122.02 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,606.93 | Professional | None | $6,165.95 | $6,165.95 | $6,606.93 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $5,495.41 | Facility | None | $724.44 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $1,202.26 | Professional | None | $891.25 | $912.01 | $1,202.26 |
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 $660.69 Median $2,137.96 Typical High $4,466.84 | Facility | None | $660.69 | $2,137.96 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $794.33 Median $812.83 Typical High $1,122.02 | Professional | None | $794.33 | $812.83 | $1,122.02 |
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 $602.56 Median $794.33 Typical High $1,148.15 | Professional | None | $602.56 | $794.33 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | None | $741.31 | $776.25 | $776.25 |
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 $446.68 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $812.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $478.63 | $575.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $190.55 | $234.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $724.44 | $870.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $173.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $114.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $812.83 |
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
$562
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.