How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,047 to $6,026Professionalmedian $316 · 10th to 90th $49 to $759
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,047.13 | Professional | None | $501.19 | $537.03 | $1,047.13 |
BCBS Texas Setting Facility Modifier None Typical Low $1,949.84 Median $3,162.28 Typical High $6,309.57 | Facility | None | $1,949.84 | $3,162.28 | $6,309.57 |
BCBS Texas Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $741.31 | Professional | None | $446.68 | $562.34 | $741.31 |
Christus Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,511.89 Typical High $3,548.13 | Facility | None | $602.56 | $2,511.89 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $707.95 | Professional | None | $467.74 | $537.03 | $707.95 |
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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,905.46 Typical High $5,495.41 | Facility | None | $512.86 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $707.95 | Professional | None | $501.19 | $537.03 | $707.95 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $407.38 | Professional | None | $44.67 | $83.18 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $794.33 Typical High $954.99 | Professional | None | $426.58 | $794.33 | $954.99 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,570.40 Typical High $4,466.84 | Facility | None | $562.34 | $2,570.40 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $537.03 Typical High $691.83 | Professional | None | $467.74 | $537.03 | $691.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $741.31 | Professional | None | $380.19 | $501.19 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | None | $416.87 | $436.52 | $436.52 |
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 $251.19 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $100.00 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $501.19 | Professional | 54 · Surgery only | $371.54 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $67.61 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $269.15 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $107.15 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $107.15 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $501.19 | Professional | 54 · Surgery only | $371.54 | $407.38 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $100.00 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $53.70 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $53.70 | $66.07 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $467.74 |
Where Texas sits
The same service costs 7.9 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
$363
WY $2,344UT $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.