How much rates vary
Facilitymedian $166 · 10th to 90th $45 to $1,660Professionalmedian $59 · 10th to 90th $24 to $120
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 $36.31 Median $54.95 Typical High $75.86 | Facility | None | $36.31 | $54.95 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $79.43 | Professional | None | $33.11 | $54.95 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $75.86 | Professional | None | $38.02 | $64.57 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $97.72 Median $181.97 Typical High $3,467.37 | Facility | None | $97.72 | $181.97 | $3,467.37 |
BCBS Texas Setting Professional Modifier None Typical Low $36.31 Median $56.23 Typical High $87.10 | Professional | None | $36.31 | $56.23 | $87.10 |
Baylor Scott & White Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Professional | None | $75.86 | $87.10 | $125.89 |
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 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 $43.65 Median $63.10 Typical High $89.13 | Professional | None | $43.65 | $63.10 | $89.13 |
Lucent Health Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $691.83 | Professional | None | $501.19 | $501.19 | $691.83 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $169.82 Typical High $630.96 | Facility | None | $40.74 | $169.82 | $630.96 |
Moda Health Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $89.13 | Professional | None | $33.11 | $54.95 | $89.13 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $54.95 Typical High $72.44 | Professional | None | $9.77 | $54.95 | $72.44 |
Oscar Health Setting Facility Modifier None Typical Low $457.09 Median $851.14 Typical High $851.14 | Facility | None | $457.09 | $851.14 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $147.91 Median $154.88 Typical High $295.12 | Professional | None | $147.91 | $154.88 | $295.12 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $66.07 Typical High $151.36 | Facility | None | $40.74 | $66.07 | $151.36 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $89.13 | Professional | None | $43.65 | $61.66 | $89.13 |
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 $32.36 Median $52.48 Typical High $81.28 | Professional | None | $32.36 | $52.48 | $81.28 |
Wellpoint Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
8 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 $16.60 Median $27.54 Typical High $34.67 | Professional | 52 · Reduced service | $16.60 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $10.96 Typical High $13.80 | Professional | 53 · Discontinued | $6.61 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $5.01 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.50 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.31 | $5.50 | $6.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $16.60 | $27.54 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $6.61 | $10.96 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $5.01 | $8.32 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.31 | $5.50 | $6.61 |
Where Texas sits
The same service costs 4.0 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· 44th of 51
$60.26
AK $195KY $48.98
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.