How much rates vary
Facilitymedian $724 · 10th to 90th $135 to $3,890Professionalmedian $195 · 10th to 90th $35 to $501
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 $870.96 Median $3,801.89 Typical High $9,120.11 | Facility | None | $870.96 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $316.23 | Professional | None | $114.82 | $208.93 | $316.23 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $281.84 | Professional | None | $104.71 | $257.04 | $281.84 |
BCBS Texas Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $2,089.30 | Facility | None | $114.82 | $190.55 | $2,089.30 |
BCBS Texas Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $354.81 | Professional | None | $117.49 | $208.93 | $354.81 |
Christus Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $208.93 Typical High $3,801.89 | Facility | None | $147.91 | $208.93 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $354.81 | Professional | None | $128.82 | $229.09 | $354.81 |
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 $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $1,819.70 Typical High $6,760.83 | Facility | None | $162.18 | $1,819.70 | $6,760.83 |
Moda Health Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $316.23 | Professional | None | $114.82 | $208.93 | $316.23 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $162.18 Typical High $218.78 | Professional | None | $28.84 | $162.18 | $218.78 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $407.38 Typical High $7,585.78 | Facility | None | $162.18 | $407.38 | $7,585.78 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $223.87 Typical High $354.81 | Professional | None | $128.82 | $223.87 | $354.81 |
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 $109.65 Median $186.21 Typical High $588.84 | Professional | None | $109.65 | $186.21 | $588.84 |
Wellpoint Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
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 $57.54 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $37.15 Typical High $50.12 | Professional | 53 · Discontinued | $22.91 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $138.04 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $138.04 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.92 Typical High $38.02 | Professional | 55 · Aftercare only | $17.38 | $26.92 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $17.78 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.48 | $17.78 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $95.50 Typical High $125.89 | Professional | 52 · Reduced service | $57.54 | $95.50 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $22.91 | $38.02 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $141.25 Typical High $190.55 | Professional | 54 · Surgery only | $85.11 | $141.25 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $28.18 Typical High $38.02 | Professional | 55 · Aftercare only | $17.38 | $28.18 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.62 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.48 | $18.62 | $25.12 |
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
$214
OK $692TX $214
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.