How much rates vary
Facilitymedian $447 · 10th to 90th $158 to $3,090Professionalmedian $178 · 10th to 90th $28 to $1,514
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 $707.95 Median $3,715.35 Typical High $9,120.11 | Facility | None | $707.95 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $218.78 | Professional | None | $154.88 | $186.21 | $218.78 |
BCBS Setting Facility Modifier None Typical Low $269.15 Median $489.78 Typical High $1,548.82 | Facility | None | $269.15 | $489.78 | $1,548.82 |
BCBS Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $380.19 | Professional | None | $141.25 | $229.09 | $380.19 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $204.17 Typical High $316.23 | Facility | None | $66.07 | $204.17 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $346.74 | Professional | None | $186.21 | $208.93 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,513.56 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $1,737.80 Typical High $6,025.60 | Facility | None | $173.78 | $1,737.80 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $263.03 | Professional | None | $154.88 | $186.21 | $263.03 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $134.90 Typical High $181.97 | Professional | None | $23.99 | $134.90 | $181.97 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $208.93 Typical High $331.13 | Facility | None | $66.07 | $208.93 | $331.13 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $346.74 | Professional | None | $186.21 | $199.53 | $346.74 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $331.13 | Professional | None | $158.49 | $218.78 | $331.13 |
Wellpoint Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $77.62 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $77.62 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $30.90 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $128.82 Typical High $147.91 | Professional | 54 · Surgery only | $117.49 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $26.30 Typical High $29.51 | Professional | 55 · Aftercare only | $23.44 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.38 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.49 | $17.38 | $19.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $87.10 Typical High $97.72 | Professional | 52 · Reduced service | $77.62 | $87.10 | $97.72 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $34.67 Typical High $39.81 | Professional | 53 · Discontinued | $30.90 | $34.67 | $39.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $128.82 Typical High $147.91 | Professional | 54 · Surgery only | $114.82 | $128.82 | $147.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.70 Typical High $29.51 | Professional | 55 · Aftercare only | $22.91 | $25.70 | $29.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $17.38 Typical High $19.95 | Professional | 56 · Pre-op care only | $15.49 | $17.38 | $19.95 |
Where Texas sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 51st of 51
$195
OK $631TX $195
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.