How much rates vary
Facilitymedian $380 · 10th to 90th $9 to $3,802Professionalmedian $5 · 10th to 90th $2 to $26
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 $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $5.25 Typical High $8.13 | Professional | None | $1.58 | $5.25 | $8.13 |
Ambetter Setting Professional Modifier None Typical Low $5.13 Median $5.50 Typical High $6.46 | Professional | None | $5.13 | $5.50 | $6.46 |
BCBS Texas Setting Facility Modifier None Typical Low $3.98 Median $2,454.71 Typical High $8,317.64 | Facility | None | $3.98 | $2,454.71 | $8,317.64 |
BCBS Texas Setting Professional Modifier None Typical Low $1.62 Median $4.79 Typical High $8.32 | Professional | None | $1.62 | $4.79 | $8.32 |
Baylor Scott & White Setting Professional Modifier None Typical Low $1.66 Median $2.69 Typical High $9.77 | Professional | None | $1.66 | $2.69 | $9.77 |
Christus Setting Facility Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,995.26 Typical High $2,691.53 | Facility | None | $50.12 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $5.75 Typical High $8.32 | Professional | None | $1.86 | $5.75 | $8.32 |
Health Smart Setting Professional Modifier None Typical Low $8.13 Median $9.12 Typical High $18.20 | Professional | None | $8.13 | $9.12 | $18.20 |
Lucent Health Setting Professional Modifier None Typical Low $10.00 Median $186.21 Typical High $186.21 | Professional | None | $10.00 | $186.21 | $186.21 |
Moda Health Setting Facility Modifier None Typical Low $4.57 Median $630.96 Typical High $4,168.69 | Facility | None | $4.57 | $630.96 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $1.58 Median $5.37 Typical High $9.12 | Professional | None | $1.58 | $5.37 | $9.12 |
Molina Setting Professional Modifier None Typical Low $1.55 Median $1.95 Typical High $5.62 | Professional | None | $1.55 | $1.95 | $5.62 |
Providence Setting Facility Modifier None Typical Low $1.74 Median $19.50 Typical High $2,691.53 | Facility | None | $1.74 | $19.50 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $1.86 Median $5.75 Typical High $8.13 | Professional | None | $1.86 | $5.75 | $8.13 |
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 $1.91 Median $4.79 Typical High $8.13 | Professional | None | $1.91 | $4.79 | $8.13 |
Wellpoint Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
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 Professional Modifier 52 · Reduced service Typical Low $0.79 Median $2.51 Typical High $3.24 | Professional | 52 · Reduced service | $0.79 | $2.51 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $1.00 Typical High $1.29 | Professional | 53 · Discontinued | $0.32 | $1.00 | $1.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.20 Median $3.80 Typical High $4.79 | Professional | 54 · Surgery only | $1.20 | $3.80 | $4.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.78 Typical High $0.98 | Professional | 55 · Aftercare only | $0.24 | $0.78 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.51 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.16 | $0.51 | $0.65 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $5.50 Median $6.03 Typical High $6.31 | Professional | 59 · Distinct service | $5.50 | $6.03 | $6.31 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $0.79 Median $2.51 Typical High $3.24 | Professional | 52 · Reduced service | $0.79 | $2.51 | $3.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $1.00 Typical High $1.29 | Professional | 53 · Discontinued | $0.32 | $1.00 | $1.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1.20 Median $3.80 Typical High $4.90 | Professional | 54 · Surgery only | $1.20 | $3.80 | $4.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.91 Typical High $1.00 | Professional | 55 · Aftercare only | $0.31 | $0.91 | $1.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.62 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.52 | $0.62 | $0.69 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $6.31 Median $7.76 Typical High $12.59 | Professional | 59 · Distinct service | $6.31 | $7.76 | $12.59 |
Where Texas sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 33rd of 51
$6.17
AK $12.88NE $4.37
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.