How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,455 to $10,000Professionalmedian $2,570 · 10th to 90th $2,455 to $10,715
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 $2,570.40 Median $3,890.45 Typical High $5,370.32 | Facility | None | $2,570.40 | $3,890.45 | $5,370.32 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,630.27 | Professional | None | $2,570.40 | $2,570.40 | $2,630.27 |
BCBS Texas Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $10,471.29 | Facility | None | $2,137.96 | $5,248.07 | $10,471.29 |
BCBS Texas Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $2,570.40 Median $4,786.30 Typical High $8,128.31 | Facility | None | $2,570.40 | $4,786.30 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $10,715.19 | Professional | None | $10,715.19 | $10,715.19 | $10,715.19 |
Moda Health Setting Facility Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $5,888.44 | Facility | None | $2,454.71 | $3,235.94 | $5,888.44 |
Moda Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | None | $2,454.71 | $2,454.71 | $2,511.89 |
Molina Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,454.71 | $2,454.71 | $2,818.38 |
Oscar Health Setting Professional Modifier None Typical Low $2,630.27 Median $4,365.16 Typical High $8,912.51 | Professional | None | $2,630.27 | $4,365.16 | $8,912.51 |
Providence Setting Facility Modifier None Typical Low $2,454.71 Median $3,630.78 Typical High $21,877.62 | Facility | None | $2,454.71 | $3,630.78 | $21,877.62 |
Providence Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $2,570.40 Typical High $2,754.23 | Professional | None | $2,454.71 | $2,570.40 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
15 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 Facility Modifier 52 · Reduced service Typical Low $1,258.93 Median $1,949.84 Typical High $2,691.53 | Facility | 52 · Reduced service | $1,258.93 | $1,949.84 | $2,691.53 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $512.86 Median $776.25 Typical High $1,071.52 | Facility | 53 · Discontinued | $512.86 | $776.25 | $1,071.52 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,951.21 Typical High $3,981.07 | Facility | 54 · Surgery only | $1,905.46 | $2,951.21 | $3,981.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $380.19 Median $588.84 Typical High $794.33 | Facility | 55 · Aftercare only | $380.19 | $588.84 | $794.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $257.04 Median $389.05 Typical High $537.03 | Facility | 56 · Pre-op care only | $257.04 | $389.05 | $537.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 53 · Discontinued | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $389.05 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 53 · Discontinued | $489.78 | $489.78 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $380.19 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $251.19 |
Where Texas sits
Rates are fairly even across states for this service. 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· 11th of 51
$2,570
AK $3,020KS $2,570
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.