How much rates vary
Facilitymedian $138 · 10th to 90th $69 to $2,188Professionalmedian $110 · 10th to 90th $26 to $214
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 $123.03 Median $3,715.35 Typical High $9,120.11 | Facility | None | $123.03 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $144.54 | Professional | None | $46.77 | $100.00 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
BCBS Texas Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $812.83 | Facility | None | $67.61 | $117.49 | $812.83 |
BCBS Texas Setting Professional Modifier None Typical Low $57.54 Median $117.49 Typical High $199.53 | Professional | None | $57.54 | $117.49 | $199.53 |
Baylor Scott & White Setting Facility Modifier None Typical Low $50.12 Median $63.10 Typical High $87.10 | Facility | None | $50.12 | $63.10 | $87.10 |
Baylor Scott & White Setting Professional Modifier None Typical Low $25.12 Median $29.51 Typical High $44.67 | Professional | None | $25.12 | $29.51 | $44.67 |
Christus Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $165.96 | Facility | None | $66.07 | $114.82 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $109.65 Typical High $177.83 | Professional | None | $60.26 | $109.65 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | None | $977.24 | $977.24 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $275.42 Typical High $5,128.61 | Facility | None | $54.95 | $275.42 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $165.96 | Professional | None | $46.77 | $100.00 | $165.96 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $147.91 | Professional | None | $19.50 | $107.15 | $147.91 |
Providence Setting Facility Modifier None Typical Low $58.88 Median $114.82 Typical High $165.96 | Facility | None | $58.88 | $114.82 | $165.96 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $181.97 | Professional | None | $60.26 | $114.82 | $181.97 |
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 $52.48 Median $91.20 Typical High $154.88 | Professional | None | $52.48 | $91.20 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $23.44 Median $51.29 Typical High $66.07 | Professional | 52 · Reduced service | $23.44 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $20.89 Typical High $26.30 | Professional | 53 · Discontinued | $9.33 | $20.89 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $77.62 Typical High $100.00 | Professional | 54 · Surgery only | $35.48 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $15.49 Typical High $19.95 | Professional | 55 · Aftercare only | $7.08 | $15.49 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $10.23 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.68 | $10.23 | $13.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $23.44 | $50.12 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $9.33 | $19.95 | $26.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $75.86 Typical High $100.00 | Professional | 54 · Surgery only | $35.48 | $75.86 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $7.08 | $15.14 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $4.68 | $10.00 | $13.18 |
Where Texas sits
The same service costs 3.2 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· 25th of 51
$117
AK $275KY $85.11
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.