How much rates vary
Facilitymedian $646 · 10th to 90th $269 to $3,802Professionalmedian $275 · 10th to 90th $59 to $2,188
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $239.88 Typical High $309.03 | Professional | None | $69.18 | $239.88 | $309.03 |
BCBS Texas Setting Facility Modifier None Typical Low $234.42 Median $407.38 Typical High $2,754.23 | Facility | None | $234.42 | $407.38 | $2,754.23 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $269.15 Typical High $467.74 | Professional | None | $83.18 | $269.15 | $467.74 |
Christus Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $398.11 Typical High $1,479.11 | Facility | None | $281.84 | $398.11 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $239.88 Typical High $416.87 | Professional | None | $95.50 | $239.88 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,187.76 | $3,019.95 | $3,019.95 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,380.38 Typical High $5,248.07 | Facility | None | $95.50 | $1,380.38 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $229.09 Typical High $309.03 | Professional | None | $69.18 | $229.09 | $309.03 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $263.03 Typical High $363.08 | Professional | None | $47.86 | $263.03 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $1,288.25 | Professional | None | $288.40 | $309.03 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $436.52 Typical High $3,801.89 | Facility | None | $275.42 | $436.52 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $245.47 Typical High $416.87 | Professional | None | $95.50 | $245.47 | $416.87 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $81.28 Median $199.53 Typical High $407.38 | Professional | None | $81.28 | $199.53 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $33.88 Median $85.11 Typical High $144.54 | Professional | 52 · Reduced service | $33.88 | $85.11 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $34.67 Typical High $57.54 | Professional | 53 · Discontinued | $13.80 | $34.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $128.82 Typical High $218.78 | Professional | 54 · Surgery only | $51.29 | $128.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $25.70 Typical High $43.65 | Professional | 55 · Aftercare only | $10.23 | $25.70 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.98 Typical High $28.84 | Professional | 56 · Pre-op care only | $6.92 | $16.98 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $85.11 Typical High $144.54 | Professional | 52 · Reduced service | $33.88 | $85.11 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $34.67 Typical High $57.54 | Professional | 53 · Discontinued | $13.80 | $34.67 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $128.82 Typical High $218.78 | Professional | 54 · Surgery only | $51.29 | $128.82 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $25.70 Typical High $43.65 | Professional | 55 · Aftercare only | $10.23 | $25.70 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.98 Typical High $28.84 | Professional | 56 · Pre-op care only | $6.92 | $16.98 | $28.84 |
Where Texas sits
The same service costs 4.3 times more in Oklahoma than in Nebraska. 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· 20th of 51
$309
OK $724NE $170
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.