How much rates vary
Facilitymedian $107 · 10th to 90th $21 to $1,047Professionalmedian $28 · 10th to 90th $14 to $200
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 $15.49 Median $26.30 Typical High $35.48 | Facility | None | $15.49 | $26.30 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $27.54 Typical High $36.31 | Professional | None | $15.49 | $27.54 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
BCBS Texas Setting Facility Modifier None Typical Low $104.71 Median $181.97 Typical High $478.63 | Facility | None | $104.71 | $181.97 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $10.47 Median $20.42 Typical High $42.66 | Professional | None | $10.47 | $20.42 | $42.66 |
Christus Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $660.69 | Facility | None | $50.12 | $66.07 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $26.92 Typical High $46.77 | Professional | None | $15.49 | $26.92 | $46.77 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | None | $199.53 | $199.53 | $234.42 |
Moda Health Setting Facility Modifier None Typical Low $12.88 Median $32.36 Typical High $169.82 | Facility | None | $12.88 | $32.36 | $169.82 |
Moda Health Setting Professional Modifier None Typical Low $15.49 Median $27.54 Typical High $36.31 | Professional | None | $15.49 | $27.54 | $36.31 |
Molina Setting Professional Modifier None Typical Low $10.72 Median $12.30 Typical High $22.91 | Professional | None | $10.72 | $12.30 | $22.91 |
Providence Setting Facility Modifier None Typical Low $12.59 Median $26.30 Typical High $66.07 | Facility | None | $12.59 | $26.30 | $66.07 |
Providence Setting Professional Modifier None Typical Low $15.49 Median $26.92 Typical High $46.77 | Professional | None | $15.49 | $26.92 | $46.77 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,398.83 | Facility | None | $141.25 | $741.31 | $2,398.83 |
United Setting Professional Modifier None Typical Low $12.88 Median $24.55 Typical High $43.65 | Professional | None | $12.88 | $24.55 | $43.65 |
Wellpoint Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
11 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 $7.76 Median $13.80 Typical High $16.98 | Professional | 52 · Reduced service | $7.76 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.62 Typical High $6.92 | Professional | 53 · Discontinued | $3.16 | $5.62 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $20.89 Typical High $25.70 | Professional | 54 · Surgery only | $11.75 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $4.17 Typical High $5.13 | Professional | 55 · Aftercare only | $2.34 | $4.17 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.75 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.55 | $2.75 | $3.47 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $32.36 Median $66.07 Typical High $186.21 | Facility | 59 · Distinct service | $32.36 | $66.07 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $14.13 Typical High $16.98 | Professional | 52 · Reduced service | $7.76 | $14.13 | $16.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.62 Typical High $6.76 | Professional | 53 · Discontinued | $3.16 | $5.62 | $6.76 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $20.89 Typical High $25.12 | Professional | 54 · Surgery only | $11.75 | $20.89 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $4.17 Typical High $5.01 | Professional | 55 · Aftercare only | $2.34 | $4.17 | $5.01 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.82 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.55 | $2.82 | $3.39 |
Where Texas sits
The same service costs 3.5 times more in Wisconsin 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· 21st of 51
$35.48
WI $87.10KY $25.12
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.