How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,820 to $14,791Professionalmedian $1,738 · 10th to 90th $316 to $8,511
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 $354.81 Median $1,862.09 Typical High $2,630.27 | Professional | None | $354.81 | $1,862.09 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $588.84 | Professional | None | $190.55 | $190.55 | $588.84 |
BCBS Texas Setting Facility Modifier None Typical Low $3,981.07 Median $7,585.78 Typical High $16,218.10 | Facility | None | $3,981.07 | $7,585.78 | $16,218.10 |
BCBS Texas Setting Professional Modifier None Typical Low $323.59 Median $1,348.96 Typical High $2,818.38 | Professional | None | $323.59 | $1,348.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $912.01 Typical High $3,019.95 | Professional | None | $389.05 | $912.01 | $3,019.95 |
Lucent Health Setting Professional Modifier None Typical Low $13,803.84 Median $16,595.87 Typical High $16,595.87 | Professional | None | $13,803.84 | $16,595.87 | $16,595.87 |
Moda Health Setting Facility Modifier None Typical Low $562.34 Median $2,454.71 Typical High $6,025.60 | Facility | None | $562.34 | $2,454.71 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $354.81 Median $1,819.70 Typical High $2,630.27 | Professional | None | $354.81 | $1,819.70 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $281.84 Median $1,621.81 Typical High $2,089.30 | Professional | None | $281.84 | $1,621.81 | $2,089.30 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $954.99 Typical High $3,388.44 | Facility | None | $354.81 | $954.99 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $912.01 Typical High $3,019.95 | Professional | None | $389.05 | $912.01 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $8,709.64 Typical High $18,620.87 | Facility | None | $2,630.27 | $8,709.64 | $18,620.87 |
United Setting Professional Modifier None Typical Low $338.84 Median $1,584.89 Typical High $3,162.28 | Professional | None | $338.84 | $1,584.89 | $3,162.28 |
Wellpoint Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $173.78 Median $831.76 Typical High $1,288.25 | Professional | 52 · Reduced service | $173.78 | $831.76 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $331.13 Typical High $512.86 | Professional | 53 · Discontinued | $70.79 | $331.13 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,230.27 Typical High $1,949.84 | Professional | 54 · Surgery only | $263.03 | $1,230.27 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $245.47 Typical High $389.05 | Professional | 55 · Aftercare only | $52.48 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $165.96 Typical High $257.04 | Professional | 56 · Pre-op care only | $35.48 | $165.96 | $257.04 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $870.96 Typical High $1,288.25 | Professional | 52 · Reduced service | $173.78 | $870.96 | $1,288.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $346.74 Typical High $524.81 | Professional | 53 · Discontinued | $70.79 | $346.74 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,288.25 Typical High $1,949.84 | Professional | 54 · Surgery only | $263.03 | $1,288.25 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $263.03 Typical High $389.05 | Professional | 55 · Aftercare only | $52.48 | $263.03 | $389.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $173.78 Typical High $263.03 | Professional | 56 · Pre-op care only | $35.48 | $173.78 | $263.03 |
Where Texas sits
The same service costs 6.9 times more in Wisconsin than in Hawaii. 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
$1,820
WI $3,162HI $457
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.