How much rates vary
Facilitymedian $182 · 10th to 90th $107 to $3,467Professionalmedian $126 · 10th to 90th $24 to $1,023
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 $162.18 Median $3,715.35 Typical High $9,120.11 | Facility | None | $162.18 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $128.82 Typical High $162.18 | Professional | None | $58.88 | $128.82 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $107.15 Median $158.49 Typical High $1,023.29 | Facility | None | $107.15 | $158.49 | $1,023.29 |
BCBS Texas Setting Professional Modifier None Typical Low $61.66 Median $128.82 Typical High $223.87 | Professional | None | $61.66 | $128.82 | $223.87 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $162.18 Typical High $2,290.87 | Facility | None | $114.82 | $162.18 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $131.83 Typical High $199.53 | Professional | None | $66.07 | $131.83 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,023.29 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $707.95 Typical High $5,128.61 | Facility | None | $60.26 | $707.95 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $131.83 Typical High $173.78 | Professional | None | $58.88 | $131.83 | $173.78 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $144.54 | Professional | None | $19.50 | $107.15 | $144.54 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $1,995.26 | Facility | None | $95.50 | $154.88 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $131.83 Typical High $199.53 | Professional | None | $66.07 | $131.83 | $199.53 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $186.21 | Professional | None | $54.95 | $107.15 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $28.84 Median $60.26 Typical High $81.28 | Professional | 52 · Reduced service | $28.84 | $60.26 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $24.55 Typical High $32.36 | Professional | 53 · Discontinued | $11.75 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $43.65 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $8.71 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $12.30 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.89 | $12.30 | $16.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $60.26 Typical High $81.28 | Professional | 52 · Reduced service | $28.84 | $60.26 | $81.28 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $24.55 Typical High $32.36 | Professional | 53 · Discontinued | $11.75 | $24.55 | $32.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $43.65 | $91.20 | $123.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $8.71 | $18.20 | $24.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $12.30 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.89 | $12.30 | $16.22 |
Where Texas sits
The same service costs 5.9 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· 33rd of 51
$138
OK $468KY $79.43
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.