How much rates vary
Facilitymedian $1,148 · 10th to 90th $398 to $4,571Professionalmedian $355 · 10th to 90th $71 to $2,630
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 $79.43 Median $398.11 Typical High $575.44 | Professional | None | $79.43 | $398.11 | $575.44 |
BCBS Texas Setting Facility Modifier None Typical Low $630.96 Median $1,148.15 Typical High $3,311.31 | Facility | None | $630.96 | $1,148.15 | $3,311.31 |
BCBS Texas Setting Professional Modifier None Typical Low $75.86 Median $316.23 Typical High $562.34 | Professional | None | $75.86 | $316.23 | $562.34 |
Christus Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $478.63 Typical High $2,691.53 | Facility | None | $338.84 | $478.63 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $588.84 | Professional | None | $85.11 | $194.98 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,630.27 | $3,162.28 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $100.00 Median $1,230.27 Typical High $5,128.61 | Facility | None | $100.00 | $1,230.27 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $398.11 Typical High $512.86 | Professional | None | $79.43 | $398.11 | $512.86 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $295.12 Typical High $398.11 | Professional | None | $53.70 | $295.12 | $398.11 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $562.34 Typical High $6,456.54 | Facility | None | $338.84 | $562.34 | $6,456.54 |
Providence Setting Professional Modifier None Typical Low $85.11 Median $208.93 Typical High $588.84 | Professional | None | $85.11 | $208.93 | $588.84 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,388.44 | Facility | None | $389.05 | $1,230.27 | $3,388.44 |
United Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $645.65 | Professional | None | $79.43 | $263.03 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $39.81 Median $186.21 Typical High $223.87 | Professional | 52 · Reduced service | $39.81 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $15.85 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $60.26 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $56.23 Typical High $66.07 | Professional | 55 · Aftercare only | $12.02 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $7.94 | $38.02 | $44.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $190.55 Typical High $223.87 | Professional | 52 · Reduced service | $39.81 | $190.55 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $75.86 Typical High $89.13 | Professional | 53 · Discontinued | $15.85 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $281.84 Typical High $331.13 | Professional | 54 · Surgery only | $60.26 | $281.84 | $331.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $12.02 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $38.02 Typical High $44.67 | Professional | 56 · Pre-op care only | $7.94 | $38.02 | $44.67 |
Where Texas sits
The same service costs 7.8 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· 29th of 51
$437
OK $1,148NE $148
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.