How much rates vary
Facilitymedian $8,710 · 10th to 90th $1,820 to $30,200Professionalmedian $776 · 10th to 90th $76 to $8,511
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 $13,182.57 | Facility | None | $1,148.15 | $4,168.69 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $4,897.79 | Professional | None | $676.08 | $870.96 | $4,897.79 |
BCBS Texas Setting Facility Modifier None Typical Low $10,471.29 Median $20,892.96 Typical High $43,651.58 | Facility | None | $10,471.29 | $20,892.96 | $43,651.58 |
BCBS Texas Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $2,344.23 | Professional | None | $954.99 | $1,348.96 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $12,022.64 Median $16,982.44 Typical High $26,915.35 | Facility | None | $12,022.64 | $16,982.44 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,288.25 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $9,120.11 Typical High $9,120.11 | Professional | None | $8,511.38 | $9,120.11 | $9,120.11 |
Moda Health Setting Facility Modifier None Typical Low $933.25 Median $2,187.76 Typical High $8,709.64 | Facility | None | $933.25 | $2,187.76 | $8,709.64 |
Moda Health Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,698.24 | Professional | None | $676.08 | $870.96 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $165.96 Typical High $977.24 | Professional | None | $28.84 | $165.96 | $977.24 |
Providence Setting Facility Modifier None Typical Low $933.25 Median $12,022.64 Typical High $46,773.51 | Facility | None | $933.25 | $12,022.64 | $46,773.51 |
Providence Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,288.25 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $18,620.87 | Facility | None | $2,630.27 | $6,165.95 | $18,620.87 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,778.28 | Professional | None | $851.14 | $1,202.26 | $1,778.28 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $338.84 Median $426.58 Typical High $537.03 | Professional | 52 · Reduced service | $338.84 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $169.82 Typical High $218.78 | Professional | 53 · Discontinued | $134.90 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $812.83 | Professional | 54 · Surgery only | $501.19 | $645.65 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $85.11 Typical High $109.65 | Professional | 56 · Pre-op care only | $67.61 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $602.56 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $467.74 | $602.56 | $758.58 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $426.58 Typical High $537.03 | Professional | 52 · Reduced service | $338.84 | $426.58 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $169.82 Typical High $213.80 | Professional | 53 · Discontinued | $134.90 | $169.82 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $812.83 | Professional | 54 · Surgery only | $501.19 | $645.65 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | 55 · Aftercare only | $100.00 | $128.82 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $85.11 Typical High $107.15 | Professional | 56 · Pre-op care only | $67.61 | $85.11 | $107.15 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $602.56 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $467.74 | $602.56 | $758.58 |
Where Texas sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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· 51st of 51
$871
OK $7,762TX $871
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.