How much rates vary
Facilitymedian $3,548 · 10th to 90th $78 to $9,772Professionalmedian $182 · 10th to 90th $23 to $1,349
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 $9,120.11 | Facility | None | $977.24 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $741.31 | Professional | None | $181.97 | $190.55 | $741.31 |
BCBS Texas Setting Facility Modifier None Typical Low $2,398.83 Median $4,265.80 Typical High $10,471.29 | Facility | None | $2,398.83 | $4,265.80 | $10,471.29 |
BCBS Texas Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $309.03 | Professional | None | $169.82 | $213.80 | $309.03 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $3,090.30 Typical High $5,754.40 | Facility | None | $1,584.89 | $3,090.30 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $338.84 | Professional | None | $194.98 | $229.09 | $338.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $45,708.82 | Professional | None | $1,348.96 | $1,348.96 | $45,708.82 |
Moda Health Setting Facility Modifier None Typical Low $190.55 Median $2,511.89 Typical High $8,317.64 | Facility | None | $190.55 | $2,511.89 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $257.04 | Professional | None | $181.97 | $190.55 | $257.04 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $109.65 Typical High $147.91 | Professional | None | $19.95 | $109.65 | $147.91 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $3,311.31 Typical High $11,748.98 | Facility | None | $630.96 | $3,311.31 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $338.84 | Professional | None | $194.98 | $229.09 | $338.84 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $154.88 Median $213.80 Typical High $323.59 | Professional | None | $154.88 | $213.80 | $323.59 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $89.13 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | 54 · Surgery only | $134.90 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 52 · Reduced service | $89.13 | $95.50 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $36.31 | $38.02 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | 54 · Surgery only | $134.90 | $141.25 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $28.18 Typical High $30.90 | Professional | 55 · Aftercare only | $26.92 | $28.18 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $18.20 | $19.05 | $20.89 |
Where Texas sits
The same service costs 10.2 times more in Oklahoma 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· 45th of 51
$234
OK $1,950KY $191
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.