How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,318 to $7,079Professionalmedian $257 · 10th to 90th $39 to $1,905
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 $257.04 Median $275.42 Typical High $1,148.15 | Professional | None | $257.04 | $275.42 | $1,148.15 |
BCBS Texas Setting Facility Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $7,762.47 | Facility | None | $1,380.38 | $2,951.21 | $7,762.47 |
BCBS Texas Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | None | $229.09 | $251.19 | $302.00 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,187.76 Typical High $2,884.03 | Facility | None | $724.44 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $467.74 | Professional | None | $269.15 | $302.00 | $467.74 |
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 $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | None | $1,905.46 | $1,905.46 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $2,570.40 Typical High $7,079.46 | Facility | None | $281.84 | $2,570.40 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $371.54 | Professional | None | $257.04 | $269.15 | $371.54 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $190.55 Typical High $257.04 | Professional | None | $34.67 | $190.55 | $257.04 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $2,290.87 Typical High $6,165.95 | Facility | None | $588.84 | $2,290.87 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $467.74 | Professional | None | $269.15 | $302.00 | $467.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $446.68 | Professional | None | $208.93 | $288.40 | $446.68 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $190.55 Median $194.98 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $194.98 Typical High $229.09 | Professional | 54 · Surgery only | $190.55 | $194.98 | $229.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $38.90 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.30 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.70 | $26.30 | $30.20 |
Where Texas sits
The same service costs 7.2 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· 36th of 51
$380
OK $1,950NY $269
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.