How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,479 to $7,762Professionalmedian $933 · 10th to 90th $245 to $11,482
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 $8,511.38 | Facility | None | $977.24 | $3,311.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $1,071.52 Typical High $1,513.56 | Professional | None | $269.15 | $1,071.52 | $1,513.56 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $776.25 Typical High $1,000.00 | Professional | None | $346.74 | $776.25 | $1,000.00 |
BCBS Texas Setting Facility Modifier None Typical Low $1,584.89 Median $3,019.95 Typical High $7,585.78 | Facility | None | $1,584.89 | $3,019.95 | $7,585.78 |
BCBS Texas Setting Professional Modifier None Typical Low $257.04 Median $851.14 Typical High $1,479.11 | Professional | None | $257.04 | $851.14 | $1,479.11 |
Baylor Scott & White Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $1,548.82 | Professional | None | $512.86 | $933.25 | $1,548.82 |
Christus Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Facility | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $4,570.88 | Facility | None | $1,548.82 | $2,137.96 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $933.25 Typical High $1,905.46 | Professional | None | $295.12 | $933.25 | $1,905.46 |
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 $11,481.54 Median $11,481.54 Typical High $11,481.54 | Professional | None | $11,481.54 | $11,481.54 | $11,481.54 |
Moda Health Setting Facility Modifier None Typical Low $389.05 Median $1,995.26 Typical High $6,760.83 | Facility | None | $389.05 | $1,995.26 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $269.15 Median $1,000.00 Typical High $1,445.44 | Professional | None | $269.15 | $1,000.00 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $776.25 Typical High $1,047.13 | Professional | None | $141.25 | $776.25 | $1,047.13 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $891.25 Typical High $2,089.30 | Professional | None | $281.84 | $891.25 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $11,481.54 | Facility | None | $912.01 | $2,187.76 | $11,481.54 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $933.25 Typical High $1,862.09 | Professional | None | $295.12 | $933.25 | $1,862.09 |
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 |
United Setting Professional Modifier None Typical Low $263.03 Median $812.83 Typical High $1,995.26 | Professional | None | $263.03 | $812.83 | $1,995.26 |
Wellpoint Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
6 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 54 · Surgery only Typical Low $204.17 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $204.17 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $40.74 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $26.92 | $100.00 | $117.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $204.17 | $758.58 | $891.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $40.74 | $151.36 | $177.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $26.92 | $100.00 | $117.49 |
Where Texas sits
The same service costs 4.8 times more in Alaska 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
$1,380
AK $2,512NE $525
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.