How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,259 to $7,413Professionalmedian $132 · 10th to 90th $22 to $1,072
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 $1,000.00 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $194.98 | Professional | None | $102.33 | $131.83 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $2,630.27 Typical High $6,456.54 | Facility | None | $1,258.93 | $2,630.27 | $6,456.54 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $288.40 | Professional | None | $120.23 | $158.49 | $288.40 |
Christus Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $3,801.89 | Facility | None | $954.99 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $229.09 | Professional | None | $125.89 | $138.04 | $229.09 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $3,467.37 Typical High $6,918.31 | Facility | None | $141.25 | $3,467.37 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $199.53 | Professional | None | $102.33 | $131.83 | $199.53 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $107.15 Typical High $144.54 | Professional | None | $19.05 | $107.15 | $144.54 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $2,344.23 Typical High $7,585.78 | Facility | None | $478.63 | $2,344.23 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $229.09 | Professional | None | $125.89 | $134.90 | $229.09 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $213.80 | Professional | None | $104.71 | $144.54 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $51.29 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.91 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $77.62 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $15.49 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $51.29 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $26.30 | Professional | 53 · Discontinued | $20.42 | $22.91 | $26.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $75.86 | $85.11 | $97.72 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $15.14 | $17.38 | $19.50 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.23 | $11.48 | $13.18 |
Where Texas sits
The same service costs 10.7 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· 33rd of 51
$186
OK $1,413NY $132
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.