How much rates vary
Facilitymedian $1,175 · 10th to 90th $501 to $2,239Professionalmedian $501 · 10th to 90th $479 to $513
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 $512.86 Median $794.33 Typical High $1,071.52 | Facility | None | $512.86 | $794.33 | $1,071.52 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $562.34 | Professional | None | $512.86 | $512.86 | $562.34 |
BCBS Texas Setting Facility Modifier None Typical Low $489.78 Median $1,202.26 Typical High $2,290.87 | Facility | None | $489.78 | $1,202.26 | $2,290.87 |
BCBS Texas Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $1,621.81 | Facility | None | $512.86 | $1,000.00 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $1,202.26 | Facility | None | $501.19 | $645.65 | $1,202.26 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | None | $501.19 | $501.19 | $549.54 |
Molina Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Providence Setting Facility Modifier None Typical Low $512.86 Median $724.44 Typical High $4,365.16 | Facility | None | $512.86 | $724.44 | $4,365.16 |
Providence Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
12 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 $257.04 Median $398.11 Typical High $537.03 | Facility | 52 · Reduced service | $257.04 | $398.11 | $537.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $102.33 Median $158.49 Typical High $213.80 | Facility | 53 · Discontinued | $102.33 | $158.49 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $162.18 | Facility | 55 · Aftercare only | $75.86 | $117.49 | $162.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $51.29 Median $79.43 Typical High $107.15 | Facility | 56 · Pre-op care only | $51.29 | $79.43 | $107.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 52 · Reduced service | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 53 · Discontinued | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $75.86 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $56.23 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $56.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $251.19 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $102.33 | Professional | 53 · Discontinued | $100.00 | $100.00 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $77.62 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $51.29 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $51.29 |
Where Texas sits
The same service costs 2.8 times more in Arizona than in Oklahoma. 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· 3rd of 51
$741
AZ $776OK $282
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.