How much rates vary
Facilitymedian $4,571 · 10th to 90th $2,089 to $11,482Professionalmedian $550 · 10th to 90th $22 to $1,380
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 $1,148.15 Median $4,168.69 Typical High $10,964.78 | Facility | None | $1,148.15 | $4,168.69 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $3,019.95 | Professional | None | $933.25 | $977.24 | $3,019.95 |
Ambetter Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,897.79 Typical High $12,589.25 | Facility | None | $2,398.83 | $4,897.79 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $3,162.28 | Professional | None | $933.25 | $1,202.26 | $3,162.28 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $3,715.35 Typical High $5,248.07 | Facility | None | $1,288.25 | $3,715.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,122.02 | $1,737.80 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,762.47 | Professional | None | $7,413.10 | $7,413.10 | $7,762.47 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,187.76 Typical High $8,128.31 | Facility | None | $933.25 | $2,187.76 | $8,128.31 |
Moda Health Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,380.38 | Professional | None | $933.25 | $977.24 | $1,380.38 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $134.90 Typical High $831.76 | Professional | None | $19.95 | $134.90 | $831.76 |
Providence Setting Facility Modifier None Typical Low $1,174.90 Median $3,890.45 Typical High $9,772.37 | Facility | None | $1,174.90 | $3,890.45 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,122.02 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,621.81 | Professional | None | $812.83 | $1,071.52 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $457.09 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $794.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $489.78 | $562.34 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $194.98 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $194.98 | $223.87 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $724.44 | $851.14 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $169.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $112.20 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $112.20 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $794.33 |
Where Texas sits
The same service costs 7.2 times more in Oklahoma 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
$692
OK $4,677UT $646
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.