How much rates vary
Facilitymedian $224 · 10th to 90th $95 to $2,951Professionalmedian $123 · 10th to 90th $30 to $214
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $151.36 | Professional | None | $45.71 | $117.49 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $128.82 Typical High $128.82 | Professional | None | $44.67 | $128.82 | $128.82 |
BCBS Texas Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $870.96 | Facility | None | $93.33 | $138.04 | $870.96 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $112.20 Typical High $165.96 | Professional | None | $44.67 | $112.20 | $165.96 |
Christus Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $169.82 Typical High $1,412.54 | Facility | None | $120.23 | $169.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $165.96 | Professional | None | $50.12 | $102.33 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $1,202.26 Typical High $6,918.31 | Facility | None | $52.48 | $1,202.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $151.36 | Professional | None | $45.71 | $117.49 | $151.36 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $131.83 Typical High $177.83 | Professional | None | $23.99 | $131.83 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $72.44 | Professional | None | $67.61 | $67.61 | $72.44 |
Providence Setting Facility Modifier None Typical Low $112.20 Median $194.98 Typical High $3,801.89 | Facility | None | $112.20 | $194.98 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $102.33 Typical High $165.96 | Professional | None | $50.12 | $102.33 | $165.96 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,090.30 | Facility | None | $389.05 | $1,288.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $40.74 Median $89.13 Typical High $147.91 | Professional | None | $40.74 | $89.13 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
12 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 $22.91 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $22.91 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $9.12 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $91.20 Typical High $109.65 | Professional | 54 · Surgery only | $34.67 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $6.92 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $4.57 | $12.30 | $14.45 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 58 · Staged procedure | $21.88 | $21.88 | $21.88 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 59 · Distinct service | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $22.91 | $61.66 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $9.12 | $24.55 | $28.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $91.20 Typical High $109.65 | Professional | 54 · Surgery only | $34.67 | $91.20 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $6.92 | $18.20 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $4.57 | $12.30 | $14.45 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 19th of 51
$126
AK $224DC $63.10
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.