How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,380 to $12,303Professionalmedian $141 · 10th to 90th $22 to $1,778
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 $134.90 Median $151.36 Typical High $3,801.89 | Professional | None | $134.90 | $151.36 | $3,801.89 |
BCBS Texas Setting Facility Modifier None Typical Low $4,168.69 Median $7,585.78 Typical High $16,982.44 | Facility | None | $4,168.69 | $7,585.78 | $16,982.44 |
BCBS Texas Setting Professional Modifier None Typical Low $125.89 Median $165.96 Typical High $309.03 | Professional | None | $125.89 | $165.96 | $309.03 |
Christus Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $3,630.78 Typical High $5,128.61 | Facility | None | $691.83 | $3,630.78 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $257.04 | Professional | None | $141.25 | $165.96 | $257.04 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $2,290.87 Typical High $6,025.60 | Facility | None | $154.88 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $151.36 Typical High $251.19 | Professional | None | $134.90 | $151.36 | $251.19 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $147.91 | Professional | None | $19.50 | $107.15 | $147.91 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $3,630.78 Typical High $6,606.93 | Facility | None | $512.86 | $3,630.78 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $257.04 | Professional | None | $141.25 | $165.96 | $257.04 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,025.60 Typical High $12,022.64 | Facility | None | $2,630.27 | $6,025.60 | $12,022.64 |
United Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $245.47 | Professional | None | $114.82 | $158.49 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $67.61 Median $74.13 Typical High $85.11 | Professional | 52 · Reduced service | $67.61 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $34.67 | Professional | 53 · Discontinued | $26.92 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $128.82 | Professional | 54 · Surgery only | $100.00 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $25.70 | Professional | 55 · Aftercare only | $20.42 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $17.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $74.13 Typical High $83.18 | Professional | 52 · Reduced service | $67.61 | $74.13 | $83.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $26.92 | $30.20 | $33.11 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $112.20 Typical High $125.89 | Professional | 54 · Surgery only | $100.00 | $112.20 | $125.89 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $22.39 Typical High $25.12 | Professional | 55 · Aftercare only | $20.42 | $22.39 | $25.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.79 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.49 | $14.79 | $16.60 |
Where Texas sits
The same service costs 20.4 times more in Kansas than in New York. 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· 13th of 51
$479
KS $3,020NY $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.