How much rates vary
Facilitymedian $10,965 · 10th to 90th $2,951 to $23,988Professionalmedian $2,951 · 10th to 90th $468 to $3,802
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 $1,230.27 Median $4,265.80 Typical High $9,772.37 | Facility | None | $1,230.27 | $4,265.80 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $4,897.79 | Professional | None | $549.54 | $562.34 | $4,897.79 |
BCBS Texas Setting Facility Modifier None Typical Low $7,244.36 Median $12,589.25 Typical High $27,542.29 | Facility | None | $7,244.36 | $12,589.25 | $27,542.29 |
BCBS Texas Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Christus Setting Facility Modifier None Typical Low $18,197.01 Median $18,197.01 Typical High $18,197.01 | Facility | None | $18,197.01 | $18,197.01 | $18,197.01 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $16,982.44 Typical High $23,988.33 | Facility | None | $758.58 | $16,982.44 | $23,988.33 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $3,801.89 | Professional | None | $2,951.21 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $3,090.30 Typical High $8,511.38 | Facility | None | $562.34 | $3,090.30 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $616.60 | Professional | None | $549.54 | $562.34 | $616.60 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $16,982.44 Typical High $23,988.33 | Facility | None | $588.84 | $16,982.44 | $23,988.33 |
Providence Setting Professional Modifier None Typical Low $407.38 Median $741.31 Typical High $741.31 | Professional | None | $407.38 | $741.31 | $741.31 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $9,772.37 Typical High $21,379.62 | Facility | None | $3,981.07 | $9,772.37 | $21,379.62 |
United Setting Professional Modifier None Typical Low $478.63 Median $676.08 Typical High $1,071.52 | Professional | None | $478.63 | $676.08 | $1,071.52 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
10 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 $269.15 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $109.65 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $281.84 | $295.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $109.65 | $112.20 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $407.38 | $426.58 | $446.68 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $81.28 | $85.11 | $89.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $58.88 |
Where Texas sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 4th of 51
$6,761
OK $14,454NY $525
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.