How much rates vary
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 $2,754.23 Typical High $7,079.46 | Facility | None | $977.24 | $2,754.23 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,479.11 | Professional | None | $954.99 | $1,023.29 | $1,479.11 |
BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $2,818.38 Typical High $8,709.64 | Facility | None | $1,380.38 | $2,818.38 | $8,709.64 |
BCBS Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Christus Setting Facility Modifier None Typical Low $11,481.54 Median $11,481.54 Typical High $11,481.54 | Facility | None | $11,481.54 | $11,481.54 | $11,481.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $4,570.88 Median $8,511.38 Typical High $8,511.38 | Professional | None | $4,570.88 | $8,511.38 | $8,511.38 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $6,918.31 | Facility | None | $707.95 | $2,570.40 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $64.57 Median $954.99 Typical High $12,302.69 | Professional | None | $64.57 | $954.99 | $12,302.69 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $537.03 Median $1,445.44 Typical High $2,691.53 | Facility | None | $537.03 | $1,445.44 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $14,791.08 | Facility | None | $2,630.27 | $6,165.95 | $14,791.08 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,621.81 | Professional | None | $794.33 | $1,047.13 | $1,621.81 |
Wellpoint Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
5 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 $467.74 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $467.74 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $204.17 | Professional | 53 · Discontinued | $190.55 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $741.31 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $102.33 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $102.33 |
Where Texas sits
The same service costs 51.3 times more in Oklahoma than in North Carolina. 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· 8th of 51
$2,570
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.