How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,514 to $7,762Professionalmedian $661 · 10th to 90th $209 to $3,802
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 $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $2,884.03 | Professional | None | $660.69 | $660.69 | $2,884.03 |
BCBS Texas Setting Facility Modifier None Typical Low $1,584.89 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,584.89 | $3,162.28 | $7,762.47 |
BCBS Texas Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | None | $371.54 | $436.52 | $436.52 |
Christus Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,398.83 Typical High $3,162.28 | Facility | None | $691.83 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $1,071.52 | Professional | None | $208.93 | $257.04 | $1,071.52 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,388.44 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $724.44 Median $3,235.94 Typical High $6,918.31 | Facility | None | $724.44 | $3,235.94 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | None | $660.69 | $660.69 | $724.44 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $6,456.54 | Facility | None | $707.95 | $2,570.40 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $1,071.52 | Professional | None | $208.93 | $257.04 | $1,071.52 |
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 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $331.13 | $331.13 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $489.78 | $489.78 | $489.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $97.72 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $66.07 |
Where Texas sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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· 9th of 51
$2,818
OK $5,370MT $79.43
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.