How much rates vary
Facilitymedian $2,188 · 10th to 90th $933 to $6,761Professionalmedian $282 · 10th to 90th $18 to $708
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 $575.44 Median $616.60 Typical High $1,096.48 | Professional | None | $575.44 | $616.60 | $1,096.48 |
BCBS Texas Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $851.14 | Professional | None | $512.86 | $645.65 | $851.14 |
Christus Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,380.38 Typical High $2,818.38 | Facility | None | $870.96 | $1,380.38 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $794.33 | Professional | None | $537.03 | $588.84 | $794.33 |
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 $4,168.69 Median $4,168.69 Typical High $4,265.80 | Professional | None | $4,168.69 | $4,168.69 | $4,265.80 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $2,511.89 Typical High $6,760.83 | Facility | None | $575.44 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $812.83 | Professional | None | $575.44 | $616.60 | $812.83 |
Molina Setting Professional Modifier None Typical Low $15.49 Median $87.10 Typical High $467.74 | Professional | None | $15.49 | $87.10 | $467.74 |
Providence Setting Facility Modifier None Typical Low $776.25 Median $1,548.82 Typical High $6,760.83 | Facility | None | $776.25 | $1,548.82 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $794.33 | Professional | None | $537.03 | $588.84 | $794.33 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $812.83 | Professional | None | $426.58 | $562.34 | $812.83 |
Wellpoint Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | None | $489.78 | $501.19 | $501.19 |
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 $288.40 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $154.88 | Professional | 53 · Discontinued | $114.82 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $77.62 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $537.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $309.03 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $309.03 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $125.89 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $467.74 | $575.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $61.66 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $61.66 | $75.86 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $537.03 |
Where Texas sits
The same service costs 8.5 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
$316
WY $2,512UT $295
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.