How much rates vary
Facilitymedian $692 · 10th to 90th $45 to $4,169Professionalmedian $145 · 10th to 90th $36 to $1,549
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $134.90 Typical High $190.55 | Professional | None | $41.69 | $134.90 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $39.81 Typical High $154.88 | Professional | None | $19.50 | $39.81 | $154.88 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,659.59 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $39.81 Median $114.82 Typical High $199.53 | Professional | None | $39.81 | $114.82 | $199.53 |
Baylor Scott & White Setting Facility Modifier None Typical Low $48.98 Median $173.78 Typical High $4,168.69 | Facility | None | $48.98 | $173.78 | $4,168.69 |
Baylor Scott & White Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $251.19 | Professional | None | $45.71 | $74.13 | $251.19 |
Christus Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $138.04 Typical High $223.87 | Professional | None | $52.48 | $138.04 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,548.82 | $1,862.09 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $151.36 Median $870.96 Typical High $6,309.57 | Facility | None | $151.36 | $870.96 | $6,309.57 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $141.25 Typical High $194.98 | Professional | None | $41.69 | $141.25 | $194.98 |
Molina Setting Professional Modifier None Typical Low $25.12 Median $141.25 Typical High $181.97 | Professional | None | $25.12 | $141.25 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $46.77 Median $102.33 Typical High $323.59 | Professional | None | $46.77 | $102.33 | $323.59 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $151.36 Typical High $269.15 | Facility | None | $45.71 | $151.36 | $269.15 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $138.04 Typical High $223.87 | Professional | None | $52.48 | $138.04 | $223.87 |
United Setting Facility Modifier None Typical Low $177.83 Median $1,348.96 Typical High $2,691.53 | Facility | None | $177.83 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $44.67 Median $107.15 Typical High $213.80 | Professional | None | $44.67 | $107.15 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
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 $21.88 Median $57.54 Typical High $89.13 | Professional | 52 · Reduced service | $21.88 | $57.54 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $23.44 Typical High $35.48 | Professional | 53 · Discontinued | $8.71 | $23.44 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $87.10 Typical High $134.90 | Professional | 54 · Surgery only | $33.11 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $17.38 Typical High $26.92 | Professional | 55 · Aftercare only | $6.61 | $17.38 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $11.48 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.37 | $11.48 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $20.89 | $66.07 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $8.32 | $26.30 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $31.62 | $97.72 | $131.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $6.31 | $19.50 | $26.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $4.17 | $13.18 | $17.78 |
Where Texas sits
The same service costs 3.9 times more in Alaska than in Virginia. 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
$148
AK $257VA $66.07
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.