How much rates vary
Facilitymedian $288 · 10th to 90th $51 to $3,236Professionalmedian $79 · 10th to 90th $21 to $151
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 $93.33 Median $3,715.35 Typical High $9,120.11 | Facility | None | $93.33 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $61.66 Typical High $109.65 | Professional | None | $25.70 | $61.66 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $91.20 Typical High $91.20 | Professional | None | $46.77 | $91.20 | $91.20 |
BCBS Texas Setting Facility Modifier None Typical Low $147.91 Median $331.13 Typical High $6,760.83 | Facility | None | $147.91 | $331.13 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $27.54 Median $70.79 Typical High $141.25 | Professional | None | $27.54 | $70.79 | $141.25 |
Baylor Scott & White Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $83.18 | Professional | None | $46.77 | $54.95 | $83.18 |
Christus Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $67.61 Typical High $128.82 | Professional | None | $32.36 | $67.61 | $128.82 |
Lucent Health Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | None | $707.95 | $707.95 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $28.84 Median $234.42 Typical High $5,248.07 | Facility | None | $28.84 | $234.42 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $25.70 Median $69.18 Typical High $123.03 | Professional | None | $25.70 | $69.18 | $123.03 |
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 $28.84 Median $66.07 Typical High $154.88 | Facility | None | $28.84 | $66.07 | $154.88 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $70.79 Typical High $131.83 | Professional | None | $32.36 | $70.79 | $131.83 |
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 $28.84 Median $60.26 Typical High $112.20 | Professional | None | $28.84 | $60.26 | $112.20 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $12.88 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $12.88 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $5.13 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $19.50 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $3.89 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.57 | $7.76 | $9.77 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 59 · Distinct service | $93.33 | $93.33 | $100.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $12.88 | $38.02 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $5.13 | $15.49 | $19.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $19.50 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $19.50 | $57.54 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $3.89 | $11.48 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $2.57 | $7.76 | $9.77 |
Where Texas sits
The same service costs 3.3 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· 23rd of 51
$83.18
AK $170KY $51.29
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.