How much rates vary
Facilitymedian $123 · 10th to 90th $56 to $2,188Professionalmedian $100 · 10th to 90th $21 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 $125.89 Median $3,715.35 Typical High $9,120.11 | Facility | None | $125.89 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $147.91 | Professional | None | $66.07 | $112.20 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | None | $114.82 | $114.82 | $125.89 |
BCBS Texas Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $812.83 | Facility | None | $75.86 | $120.23 | $812.83 |
BCBS Texas Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $186.21 | Professional | None | $56.23 | $104.71 | $186.21 |
Christus Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $95.50 Typical High $151.36 | Facility | None | $66.07 | $95.50 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $165.96 | Professional | None | $70.79 | $112.20 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | None | $891.25 | $891.25 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $645.65 Typical High $5,248.07 | Facility | None | $66.07 | $645.65 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $169.82 | Professional | None | $66.07 | $117.49 | $169.82 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $173.78 | Facility | None | $66.07 | $100.00 | $173.78 |
Providence Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $165.96 | Professional | None | $70.79 | $112.20 | $165.96 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $162.18 | Professional | None | $60.26 | $100.00 | $162.18 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $33.11 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $33.11 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $13.18 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $50.12 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $10.00 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.61 | $11.48 | $13.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $33.11 | $57.54 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $13.18 | $22.91 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $50.12 | $87.10 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $10.00 | $17.38 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.61 | $11.48 | $13.80 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 48th of 51
$102
AK $316MD $95.50
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.