How much rates vary
Facilitymedian $525 · 10th to 90th $132 to $3,388Professionalmedian $87 · 10th to 90th $23 to $676
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $79.43 | Professional | None | $58.88 | $69.18 | $79.43 |
BCBS Texas Setting Facility Modifier None Typical Low $234.42 Median $416.87 Typical High $2,570.40 | Facility | None | $234.42 | $416.87 | $2,570.40 |
BCBS Texas Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
Christus Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $489.78 Typical High $676.08 | Facility | None | $66.07 | $489.78 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | None | $72.44 | $87.10 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $676.08 | Professional | None | $575.44 | $676.08 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $1,995.26 Typical High $6,918.31 | Facility | None | $75.86 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $69.18 Typical High $77.62 | Professional | None | $58.88 | $69.18 | $77.62 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $478.63 Typical High $676.08 | Facility | None | $66.07 | $478.63 | $676.08 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $112.20 | Professional | None | $72.44 | $87.10 | $112.20 |
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 $58.88 Median $77.62 Typical High $104.71 | Professional | None | $58.88 | $77.62 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $28.84 Median $34.67 Typical High $38.02 | Professional | 52 · Reduced service | $28.84 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $11.75 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $51.29 Typical High $56.23 | Professional | 54 · Surgery only | $43.65 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.89 | $6.92 | $7.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $34.67 Typical High $38.02 | Professional | 52 · Reduced service | $28.84 | $34.67 | $38.02 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $11.75 | $13.80 | $15.14 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $51.29 Typical High $56.23 | Professional | 54 · Surgery only | $43.65 | $51.29 | $56.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $11.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.89 | $6.92 | $7.59 |
Where Texas sits
The same service costs 5.5 times more in Arkansas 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· 5th of 51
$195
AR $331KY $60.26
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.