How much rates vary
Facilitymedian $1,148 · 10th to 90th $151 to $3,981Professionalmedian $214 · 10th to 90th $41 to $1,698
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 $60.26 Median $208.93 Typical High $269.15 | Professional | None | $60.26 | $208.93 | $269.15 |
BCBS Texas Setting Facility Modifier None Typical Low $1,148.15 Median $3,715.35 Typical High $7,943.28 | Facility | None | $1,148.15 | $3,715.35 | $7,943.28 |
BCBS Texas Setting Professional Modifier None Typical Low $67.61 Median $213.80 Typical High $457.09 | Professional | None | $67.61 | $213.80 | $457.09 |
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 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $398.11 | Professional | None | $77.62 | $199.53 | $398.11 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,698.24 | $2,041.74 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $85.11 Median $1,288.25 Typical High $5,248.07 | Facility | None | $85.11 | $1,288.25 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $199.53 Typical High $269.15 | Professional | None | $60.26 | $199.53 | $269.15 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $186.21 Typical High $251.19 | Professional | None | $33.88 | $186.21 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $870.96 | Professional | None | $239.88 | $257.04 | $870.96 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $588.84 Typical High $2,691.53 | Facility | None | $69.18 | $588.84 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $398.11 | Professional | None | $77.62 | $199.53 | $398.11 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $70.79 Median $173.78 Typical High $389.05 | Professional | None | $70.79 | $173.78 | $389.05 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $30.20 Median $70.79 Typical High $125.89 | Professional | 52 · Reduced service | $30.20 | $70.79 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $28.18 Typical High $50.12 | Professional | 53 · Discontinued | $12.02 | $28.18 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $104.71 Typical High $190.55 | Professional | 54 · Surgery only | $44.67 | $104.71 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $20.89 Typical High $38.02 | Professional | 55 · Aftercare only | $9.12 | $20.89 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $14.13 Typical High $25.12 | Professional | 56 · Pre-op care only | $6.03 | $14.13 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $70.79 Typical High $128.82 | Professional | 52 · Reduced service | $30.20 | $70.79 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $28.18 Typical High $51.29 | Professional | 53 · Discontinued | $12.02 | $28.18 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $104.71 Typical High $190.55 | Professional | 54 · Surgery only | $44.67 | $104.71 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $20.89 Typical High $38.02 | Professional | 55 · Aftercare only | $9.12 | $20.89 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $14.13 Typical High $25.70 | Professional | 56 · Pre-op care only | $6.03 | $14.13 | $25.70 |
Where Texas sits
The same service costs 4.5 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· 34th of 51
$229
OK $575NE $129
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.