How much rates vary
Facilitymedian $282 · 10th to 90th $43 to $2,399Professionalmedian $51 · 10th to 90th $21 to $93
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 $426.58 Median $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $43.65 Typical High $72.44 | Professional | None | $22.39 | $43.65 | $72.44 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $60.26 | Professional | None | $46.77 | $54.95 | $60.26 |
BCBS Texas Setting Facility Modifier None Typical Low $123.03 Median $288.40 Typical High $1,548.82 | Facility | None | $123.03 | $288.40 | $1,548.82 |
BCBS Texas Setting Professional Modifier None Typical Low $23.99 Median $46.77 Typical High $79.43 | Professional | None | $23.99 | $46.77 | $79.43 |
Baylor Scott & White Setting Professional Modifier None Typical Low $23.99 Median $38.90 Typical High $69.18 | Professional | None | $23.99 | $38.90 | $69.18 |
Christus Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
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 $28.18 Median $50.12 Typical High $74.13 | Professional | None | $28.18 | $50.12 | $74.13 |
Health Smart Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | None | $63.10 | $77.62 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
Moda Health Setting Facility Modifier None Typical Low $33.11 Median $707.95 Typical High $4,168.69 | Facility | None | $33.11 | $707.95 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $22.39 Median $43.65 Typical High $79.43 | Professional | None | $22.39 | $43.65 | $79.43 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $74.13 | Professional | None | $9.77 | $53.70 | $74.13 |
Providence Setting Facility Modifier None Typical Low $24.55 Median $58.88 Typical High $338.84 | Facility | None | $24.55 | $58.88 | $338.84 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $50.12 Typical High $74.13 | Professional | None | $28.18 | $50.12 | $74.13 |
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 $25.12 Median $42.66 Typical High $67.61 | Professional | None | $25.12 | $42.66 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
13 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 $11.22 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $11.22 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $8.51 Typical High $10.72 | Professional | 53 · Discontinued | $4.47 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $32.36 Typical High $40.74 | Professional | 54 · Surgery only | $16.60 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $6.46 Typical High $8.13 | Professional | 55 · Aftercare only | $3.31 | $6.46 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $4.27 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.24 | $4.27 | $5.37 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 59 · Distinct service | $52.48 | $54.95 | $54.95 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $46.77 Median $54.95 Typical High $57.54 | Professional | 79 · Unrelated procedure after surgery | $46.77 | $54.95 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $21.38 Typical High $26.92 | Professional | 52 · Reduced service | $11.22 | $21.38 | $26.92 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $8.51 Typical High $10.72 | Professional | 53 · Discontinued | $4.47 | $8.51 | $10.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $16.60 Median $31.62 Typical High $40.74 | Professional | 54 · Surgery only | $16.60 | $31.62 | $40.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $6.31 Typical High $8.13 | Professional | 55 · Aftercare only | $3.31 | $6.31 | $8.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $4.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.57 | $4.37 | $5.50 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $6.46 Median $47.86 Typical High $97.72 | Professional | 59 · Distinct service | $6.46 | $47.86 | $97.72 |
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· 29th of 51
$54.95
AK $151KY $42.66
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.