How much rates vary
Facilitymedian $2,951 · 10th to 90th $617 to $6,026Professionalmedian $355 · 10th to 90th $56 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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $1,548.82 | Professional | None | $338.84 | $363.08 | $1,548.82 |
BCBS Texas Setting Facility Modifier None Typical Low $1,737.80 Median $9,120.11 Typical High $12,302.69 | Facility | None | $1,737.80 | $9,120.11 | $12,302.69 |
BCBS Texas Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $524.81 | Professional | None | $275.42 | $338.84 | $524.81 |
Christus Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $3,090.30 Typical High $4,466.84 | Facility | None | $457.09 | $3,090.30 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $616.60 | Professional | None | $363.08 | $407.38 | $616.60 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,570.40 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,819.70 Typical High $5,248.07 | Facility | None | $371.54 | $1,819.70 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $512.86 | Professional | None | $338.84 | $354.81 | $512.86 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $275.42 Typical High $363.08 | Professional | None | $48.98 | $275.42 | $363.08 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $2,951.21 Typical High $4,265.80 | Facility | None | $426.58 | $2,951.21 | $4,265.80 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $616.60 | Professional | None | $363.08 | $407.38 | $616.60 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $588.84 | Professional | None | $281.84 | $389.05 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $169.82 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $40.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $169.82 Median $173.78 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $173.78 | $204.17 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $69.18 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $69.18 | $81.28 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $263.03 | $309.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $52.48 | $61.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $34.67 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $34.67 | $40.74 |
Where Texas sits
The same service costs 7.8 times more in Oklahoma 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· 49th of 51
$380
OK $2,630NY $339
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.