How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,738 to $13,804Professionalmedian $2,884 · 10th to 90th $1,148 to $10,471
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 $1,202.26 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,202.26 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,174.90 | $1,202.26 | $1,258.93 |
BCBS Texas Setting Facility Modifier None Typical Low $5,754.40 Median $10,000.00 Typical High $22,387.21 | Facility | None | $5,754.40 | $10,000.00 | $22,387.21 |
Christus Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Facility | None | $5,754.40 | $5,754.40 | $5,754.40 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,370.32 Typical High $7,585.78 | Facility | None | $758.58 | $5,370.32 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $8,511.38 Median $10,471.29 Typical High $10,471.29 | Professional | None | $8,511.38 | $10,471.29 | $10,471.29 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $3,467.37 Typical High $6,918.31 | Facility | None | $977.24 | $3,467.37 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,174.90 | $1,202.26 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $5,495.41 Typical High $7,585.78 | Facility | None | $758.58 | $5,495.41 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,165.95 | $15,135.61 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,949.84 | Professional | None | $977.24 | $1,288.25 | $1,949.84 |
Wellpoint Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $575.44 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $125.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $575.44 | $602.56 | $630.96 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $239.88 | $251.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $912.01 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $125.89 |
Where Texas sits
The same service costs 5.9 times more in Texas than in Kentucky. 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
$5,754
TX $5,754KY $977
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.