How much rates vary
Facilitymedian $11,220 · 10th to 90th $2,630 to $25,704Professionalmedian $372 · 10th to 90th $29 to $851
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 $1,258.93 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,258.93 | $4,265.80 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $2,511.89 | Professional | None | $549.54 | $575.44 | $2,511.89 |
BCBS Texas Setting Facility Modifier None Typical Low $9,120.11 Median $15,488.17 Typical High $33,884.42 | Facility | None | $9,120.11 | $15,488.17 | $33,884.42 |
BCBS Texas Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $812.83 | Professional | None | $588.84 | $630.96 | $812.83 |
Christus Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $12,589.25 | Facility | None | $12,589.25 | $12,589.25 | $12,589.25 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $11,748.98 Typical High $16,982.44 | Facility | None | $758.58 | $11,748.98 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,023.29 | Professional | None | $630.96 | $724.44 | $1,023.29 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,677.35 | $4,786.30 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $3,467.37 Typical High $9,772.37 | Facility | None | $660.69 | $3,467.37 | $9,772.37 |
Moda Health Setting Professional Modifier None Typical Low $549.54 Median $575.44 Typical High $891.25 | Professional | None | $549.54 | $575.44 | $891.25 |
Molina Setting Professional Modifier None Typical Low $12.02 Median $85.11 Typical High $512.86 | Professional | None | $12.02 | $85.11 | $512.86 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $11,748.98 Typical High $16,982.44 | Facility | None | $630.96 | $11,748.98 | $16,982.44 |
Providence Setting Professional Modifier None Typical Low $630.96 Median $724.44 Typical High $1,047.13 | Professional | None | $630.96 | $724.44 | $1,047.13 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,165.95 | $15,848.93 |
United Setting Professional Modifier None Typical Low $489.78 Median $676.08 Typical High $1,023.29 | Professional | None | $489.78 | $676.08 | $1,023.29 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $275.42 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $66.07 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $288.40 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $288.40 | $331.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $117.49 Typical High $131.83 | Professional | 53 · Discontinued | $109.65 | $117.49 | $131.83 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $436.52 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $436.52 | $501.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $87.10 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $87.10 | $100.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $57.54 | $66.07 |
Where Texas sits
The same service costs 11.7 times more in Oklahoma than in Utah. 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· 50th of 51
$437
OK $4,786UT $407
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.