How much rates vary
Facilitymedian $2,884 · 10th to 90th $275 to $6,166Professionalmedian $537 · 10th to 90th $115 to $4,169
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 $707.95 Median $2,570.40 Typical High $6,918.31 | Facility | None | $707.95 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $512.86 Typical High $794.33 | Professional | None | $134.90 | $512.86 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $389.05 | Professional | None | $120.23 | $147.91 | $389.05 |
BCBS Texas Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,949.84 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $128.82 Median $436.52 Typical High $812.83 | Professional | None | $128.82 | $436.52 | $812.83 |
Christus Setting Facility Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,165.95 | Facility | None | $6,165.95 | $6,165.95 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $831.76 | Professional | None | $158.49 | $354.81 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,897.79 | Professional | None | $4,168.69 | $4,168.69 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $1,905.46 Typical High $5,623.41 | Facility | None | $269.15 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $478.63 Typical High $794.33 | Professional | None | $134.90 | $478.63 | $794.33 |
Molina Setting Professional Modifier None Typical Low $89.13 Median $512.86 Typical High $660.69 | Professional | None | $89.13 | $512.86 | $660.69 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $537.03 Typical High $1,023.29 | Facility | None | $144.54 | $537.03 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $831.76 | Professional | None | $158.49 | $354.81 | $831.76 |
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 $131.83 Median $407.38 Typical High $870.96 | Professional | None | $131.83 | $407.38 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $67.61 Median $239.88 Typical High $380.19 | Professional | 52 · Reduced service | $67.61 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $95.50 Typical High $151.36 | Professional | 53 · Discontinued | $26.92 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $363.08 Typical High $575.44 | Professional | 54 · Surgery only | $100.00 | $363.08 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $72.44 Typical High $114.82 | Professional | 55 · Aftercare only | $19.95 | $72.44 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $47.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $13.49 | $47.86 | $75.86 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $60.26 Median $60.26 Typical High $123.03 | Professional | 51 · Multiple procedures | $60.26 | $60.26 | $123.03 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 59 · Distinct service | $112.20 | $120.23 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $269.15 Typical High $380.19 | Professional | 52 · Reduced service | $67.61 | $269.15 | $380.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $107.15 Typical High $151.36 | Professional | 53 · Discontinued | $26.92 | $107.15 | $151.36 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $398.11 Typical High $562.34 | Professional | 54 · Surgery only | $100.00 | $398.11 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $79.43 Typical High $114.82 | Professional | 55 · Aftercare only | $19.95 | $79.43 | $114.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $53.70 Typical High $75.86 | Professional | 56 · Pre-op care only | $13.49 | $53.70 | $75.86 |
Where Texas sits
The same service costs 3.8 times more in Wisconsin 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· 27th of 51
$550
WI $912NE $240
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.