How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,445 to $8,128Professionalmedian $331 · 10th to 90th $23 to $813
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 $645.65 Median $691.83 Typical High $1,122.02 | Professional | None | $645.65 | $691.83 | $1,122.02 |
BCBS Texas Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $8,317.64 | Facility | None | $1,513.56 | $3,235.94 | $8,317.64 |
BCBS Texas Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $954.99 | Professional | None | $575.44 | $741.31 | $954.99 |
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 $870.96 Median $2,137.96 Typical High $3,311.31 | Facility | None | $870.96 | $2,137.96 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $954.99 | Professional | None | $602.56 | $691.83 | $954.99 |
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 $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $645.65 Median $2,511.89 Typical High $6,760.83 | Facility | None | $645.65 | $2,511.89 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $912.01 | Professional | None | $645.65 | $691.83 | $912.01 |
Molina Setting Professional Modifier None Typical Low $20.42 Median $104.71 Typical High $524.81 | Professional | None | $20.42 | $104.71 | $524.81 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $2,238.72 Typical High $6,760.83 | Facility | None | $794.33 | $2,238.72 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $602.56 Median $691.83 Typical High $933.25 | Professional | None | $602.56 | $691.83 | $933.25 |
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 $489.78 Median $660.69 Typical High $954.99 | Professional | None | $489.78 | $660.69 | $954.99 |
Wellpoint Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $549.54 | Professional | None | $537.03 | $549.54 | $549.54 |
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 $323.59 Median $346.74 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $346.74 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $128.82 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $645.65 | Professional | 54 · Surgery only | $478.63 | $524.81 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $128.82 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $602.56 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $346.74 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $346.74 | $426.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $173.78 | Professional | 53 · Discontinued | $128.82 | $138.04 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $645.65 | Professional | 54 · Surgery only | $478.63 | $524.81 | $645.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $128.82 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $128.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $85.11 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $602.56 |
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
$417
WY $3,020UT $355
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.