How much rates vary
Facilitymedian $1,585 · 10th to 90th $575 to $4,074Professionalmedian $282 · 10th to 90th $51 to $2,239
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 $676.08 Median $2,570.40 Typical High $6,918.31 | Facility | None | $676.08 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $398.11 | Professional | None | $158.49 | $302.00 | $398.11 |
BCBS Texas Setting Facility Modifier None Typical Low $1,445.44 Median $2,570.40 Typical High $5,128.61 | Facility | None | $1,445.44 | $2,570.40 | $5,128.61 |
BCBS Texas Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $389.05 | Professional | None | $128.82 | $239.88 | $389.05 |
Christus Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,047.13 Typical High $1,659.59 | Facility | None | $457.09 | $1,047.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $436.52 | Professional | None | $165.96 | $302.00 | $436.52 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,691.53 | Professional | None | $2,238.72 | $2,238.72 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $1,122.02 Typical High $4,786.30 | Facility | None | $194.98 | $1,122.02 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $407.38 | Professional | None | $158.49 | $288.40 | $407.38 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $239.88 Typical High $323.59 | Professional | None | $43.65 | $239.88 | $323.59 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $1,096.48 Typical High $3,801.89 | Facility | None | $316.23 | $1,096.48 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $436.52 | Professional | None | $165.96 | $302.00 | $436.52 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $407.38 | Professional | None | $138.04 | $245.47 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $79.43 Median $138.04 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $31.62 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $204.17 Typical High $269.15 | Professional | 54 · Surgery only | $117.49 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $23.44 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $36.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $138.04 Typical High $181.97 | Professional | 52 · Reduced service | $79.43 | $138.04 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $31.62 | $54.95 | $72.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $204.17 Typical High $269.15 | Professional | 54 · Surgery only | $117.49 | $204.17 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $41.69 Typical High $53.70 | Professional | 55 · Aftercare only | $23.44 | $41.69 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $36.31 |
Where Texas sits
The same service costs 3.9 times more in Alaska 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· 35th of 51
$324
AK $933KY $240
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.