How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,000 to $7,762Professionalmedian $776 · 10th to 90th $295 to $3,467
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 $977.24 Median $3,311.31 Typical High $9,120.11 | Facility | None | $977.24 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $3,801.89 | Professional | None | $537.03 | $562.34 | $3,801.89 |
BCBS Texas Setting Facility Modifier None Typical Low $2,951.21 Median $3,235.94 Typical High $3,630.78 | Facility | None | $2,951.21 | $3,235.94 | $3,630.78 |
Christus Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $3,467.37 | Facility | None | $758.58 | $2,570.40 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $2,570.40 Typical High $6,918.31 | Facility | None | $562.34 | $2,570.40 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $588.84 | Professional | None | $537.03 | $562.34 | $588.84 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $2,570.40 Typical High $3,467.37 | Facility | None | $588.84 | $2,570.40 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $446.68 Median $630.96 Typical High $1,000.00 | Professional | None | $446.68 | $630.96 | $1,000.00 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $436.52 | Professional | 54 · Surgery only | $407.38 | $426.58 | $436.52 |
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 $53.70 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $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 $436.52 | Professional | 54 · Surgery only | $407.38 | $426.58 | $436.52 |
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 $53.70 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $56.23 | $58.88 |
Where Texas sits
The same service costs 10.2 times more in Texas 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· 1st of 51
$2,692
TX $2,692NY $263
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.