How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,738 to $8,710Professionalmedian $1,148 · 10th to 90th $214 to $8,710
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 $851.14 Median $2,570.40 Typical High $6,918.31 | Facility | None | $851.14 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $1,230.27 Typical High $1,737.80 | Professional | None | $251.19 | $1,230.27 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $4,570.88 Typical High $10,232.93 | Facility | None | $2,630.27 | $4,570.88 | $10,232.93 |
BCBS Texas Setting Professional Modifier None Typical Low $234.42 Median $1,071.52 Typical High $1,862.09 | Professional | None | $234.42 | $1,071.52 | $1,862.09 |
Christus Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $758.58 Typical High $1,905.46 | Professional | None | $288.40 | $758.58 | $1,905.46 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $10,715.19 Typical High $10,715.19 | Professional | None | $8,709.64 | $10,715.19 | $10,715.19 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $2,290.87 Typical High $5,495.41 | Facility | None | $549.54 | $2,290.87 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $251.19 Median $1,174.90 Typical High $1,737.80 | Professional | None | $251.19 | $1,174.90 | $1,737.80 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $1,047.13 Typical High $1,348.96 | Professional | None | $181.97 | $1,047.13 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $954.99 Typical High $2,187.76 | Facility | None | $251.19 | $954.99 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $758.58 Typical High $1,905.46 | Professional | None | $288.40 | $758.58 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $5,754.40 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,754.40 | $11,220.18 |
United Setting Professional Modifier None Typical Low $245.47 Median $1,000.00 Typical High $2,041.74 | Professional | None | $245.47 | $1,000.00 | $2,041.74 |
Wellpoint Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $125.89 Median $575.44 Typical High $831.76 | Professional | 52 · Reduced service | $125.89 | $575.44 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $229.09 Typical High $331.13 | Professional | 53 · Discontinued | $50.12 | $229.09 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $870.96 Typical High $1,258.93 | Professional | 54 · Surgery only | $186.21 | $870.96 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $173.78 Typical High $251.19 | Professional | 55 · Aftercare only | $37.15 | $173.78 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $114.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $25.12 | $114.82 | $165.96 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $575.44 Typical High $831.76 | Professional | 52 · Reduced service | $125.89 | $575.44 | $831.76 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $229.09 Typical High $331.13 | Professional | 53 · Discontinued | $50.12 | $229.09 | $331.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $870.96 Typical High $1,230.27 | Professional | 54 · Surgery only | $186.21 | $870.96 | $1,230.27 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $173.78 Typical High $251.19 | Professional | 55 · Aftercare only | $37.15 | $173.78 | $251.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $114.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $25.12 | $114.82 | $165.96 |
Where Texas sits
The same service costs 4.7 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· 33rd of 51
$1,202
WI $2,089NE $447
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.