How much rates vary
Facilitymedian $891 · 10th to 90th $195 to $3,890Professionalmedian $309 · 10th to 90th $117 to $2,512
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 $2,398.83 Typical High $6,918.31 | Facility | None | $575.44 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $316.23 Typical High $446.68 | Professional | None | $131.83 | $316.23 | $446.68 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | None | $186.21 | $275.42 | $275.42 |
BCBS Texas Setting Facility Modifier None Typical Low $1,380.38 Median $3,311.31 Typical High $8,709.64 | Facility | None | $1,380.38 | $3,311.31 | $8,709.64 |
BCBS Texas Setting Professional Modifier None Typical Low $125.89 Median $269.15 Typical High $467.74 | Professional | None | $125.89 | $269.15 | $467.74 |
Christus Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,995.26 Typical High $2,691.53 | Facility | None | $630.96 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $288.40 Typical High $549.54 | Professional | None | $144.54 | $288.40 | $549.54 |
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 $2,511.89 Median $2,511.89 Typical High $2,691.53 | Professional | None | $2,511.89 | $2,511.89 | $2,691.53 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $1,230.27 Typical High $5,495.41 | Facility | None | $194.98 | $1,230.27 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $309.03 Typical High $426.58 | Professional | None | $131.83 | $309.03 | $426.58 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $269.15 Typical High $363.08 | Professional | None | $48.98 | $269.15 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $676.08 | Professional | None | $134.90 | $302.00 | $676.08 |
Providence Setting Facility Modifier None Typical Low $151.36 Median $831.76 Typical High $2,691.53 | Facility | None | $151.36 | $831.76 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $288.40 Typical High $537.03 | Professional | None | $144.54 | $288.40 | $537.03 |
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 $128.82 Median $251.19 Typical High $562.34 | Professional | None | $128.82 | $251.19 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $100.00 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $100.00 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $19.95 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $13.18 | $29.51 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $100.00 | $223.87 | $263.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $44.67 Typical High $52.48 | Professional | 55 · Aftercare only | $19.95 | $44.67 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $29.51 Typical High $34.67 | Professional | 56 · Pre-op care only | $13.18 | $29.51 | $34.67 |
Where Texas sits
The same service costs 3.4 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· 39th of 51
$331
AK $759NE $224
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.