How much rates vary
Facilitymedian $977 · 10th to 90th $166 to $5,623Professionalmedian $132 · 10th to 90th $56 to $1,202
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $234.42 | Professional | None | $69.18 | $173.78 | $234.42 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $208.93 | Professional | None | $57.54 | $79.43 | $208.93 |
BCBS Texas Setting Facility Modifier None Typical Low $6,309.57 Median $19,498.45 Typical High $19,498.45 | Facility | None | $6,309.57 | $19,498.45 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $56.23 Median $123.03 Typical High $223.87 | Professional | None | $56.23 | $123.03 | $223.87 |
Christus Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $263.03 | Professional | None | $75.86 | $144.54 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,479.11 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $1,412.54 Typical High $5,623.41 | Facility | None | $169.82 | $1,412.54 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $239.88 | Professional | None | $69.18 | $173.78 | $239.88 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $109.65 Typical High $147.91 | Professional | None | $19.95 | $109.65 | $147.91 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $162.18 Typical High $281.84 | Facility | None | $69.18 | $162.18 | $281.84 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $251.19 | Professional | None | $75.86 | $144.54 | $251.19 |
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 $66.07 Median $144.54 Typical High $281.84 | Professional | None | $66.07 | $144.54 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
13 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 $33.88 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $33.88 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $13.80 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $51.29 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $10.23 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.92 | $16.60 | $21.38 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $61.66 Median $61.66 Typical High $162.18 | Professional | 59 · Distinct service | $61.66 | $61.66 | $162.18 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 79 · Unrelated procedure after surgery | $61.66 | $61.66 | $61.66 |
Ambetter Setting Professional Modifier XS · Separate structure Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | XS · Separate structure | $151.36 | $151.36 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $33.88 | $83.18 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $33.11 Typical High $42.66 | Professional | 53 · Discontinued | $13.80 | $33.11 | $42.66 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $51.29 | $123.03 | $158.49 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $10.23 | $24.55 | $31.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.60 Typical High $21.38 | Professional | 56 · Pre-op care only | $6.92 | $16.60 | $21.38 |
Where Texas sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 46th of 51
$138
WI $316UT $117
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.