How much rates vary
Facilitymedian $148 · 10th to 90th $49 to $2,089Professionalmedian $72 · 10th to 90th $19 to $135
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $64.57 Typical High $89.13 | Professional | None | $21.88 | $64.57 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $77.62 | Professional | None | $38.90 | $38.90 | $77.62 |
BCBS Texas Setting Facility Modifier None Typical Low $41.69 Median $75.86 Typical High $537.03 | Facility | None | $41.69 | $75.86 | $537.03 |
BCBS Texas Setting Professional Modifier None Typical Low $22.91 Median $64.57 Typical High $109.65 | Professional | None | $22.91 | $64.57 | $109.65 |
Christus Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $83.18 Typical High $131.83 | Facility | None | $61.66 | $83.18 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $63.10 Typical High $107.15 | Professional | None | $26.92 | $63.10 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | None | $645.65 | $645.65 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $36.31 Median $977.24 Typical High $4,570.88 | Facility | None | $36.31 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $21.88 Median $66.07 Typical High $91.20 | Professional | None | $21.88 | $66.07 | $91.20 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $128.82 | Facility | None | $50.12 | $83.18 | $128.82 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $63.10 Typical High $109.65 | Professional | None | $26.92 | $63.10 | $109.65 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $25.70 Median $56.23 Typical High $95.50 | Professional | None | $25.70 | $56.23 | $95.50 |
Wellpoint Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
11 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 $10.96 Median $33.88 Typical High $43.65 | Professional | 52 · Reduced service | $10.96 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $13.80 Typical High $17.38 | Professional | 53 · Discontinued | $4.37 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $51.29 Typical High $66.07 | Professional | 54 · Surgery only | $16.22 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $10.23 Typical High $13.18 | Professional | 55 · Aftercare only | $3.24 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.19 | $6.92 | $8.71 |
Ambetter Setting Professional Modifier Q8 · Foot care: two class B findings Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | Q8 · Foot care: two class B findings | $85.11 | $85.11 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.96 Median $33.11 Typical High $43.65 | Professional | 52 · Reduced service | $10.96 | $33.11 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $4.37 | $13.18 | $17.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $16.22 Median $48.98 Typical High $66.07 | Professional | 54 · Surgery only | $16.22 | $48.98 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $3.24 | $9.77 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.19 | $6.92 | $8.71 |
Where Texas sits
The same service costs 3.5 times more in Alaska 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· 20th of 51
$79.43
AK $151KY $43.65
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.