How much rates vary
Facilitymedian $398 · 10th to 90th $135 to $4,074Professionalmedian $178 · 10th to 90th $35 to $316
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 $223.87 Median $3,630.78 Typical High $8,709.64 | Facility | None | $223.87 | $3,630.78 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $151.36 Typical High $275.42 | Professional | None | $42.66 | $151.36 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $79.43 | Professional | None | $34.67 | $37.15 | $79.43 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,659.59 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $40.74 Median $144.54 Typical High $309.03 | Professional | None | $40.74 | $144.54 | $309.03 |
Baylor Scott & White Setting Facility Modifier None Typical Low $42.66 Median $436.52 Typical High $4,466.84 | Facility | None | $42.66 | $436.52 | $4,466.84 |
Baylor Scott & White Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $61.66 | Professional | None | $37.15 | $38.02 | $61.66 |
Christus Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $134.90 Typical High $281.84 | Professional | None | $45.71 | $134.90 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $213.80 Median $489.78 Typical High $3,715.35 | Facility | None | $213.80 | $489.78 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $141.25 Typical High $281.84 | Professional | None | $42.66 | $141.25 | $281.84 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $169.82 Typical High $218.78 | Professional | None | $29.51 | $169.82 | $218.78 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $213.80 Typical High $398.11 | Facility | None | $42.66 | $213.80 | $398.11 |
Providence Setting Professional Modifier None Typical Low $45.71 Median $134.90 Typical High $281.84 | Professional | None | $45.71 | $134.90 | $281.84 |
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 $39.81 Median $144.54 Typical High $281.84 | Professional | None | $39.81 | $144.54 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
9 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 $21.38 Median $75.86 Typical High $120.23 | Professional | 52 · Reduced service | $21.38 | $75.86 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $30.90 Typical High $47.86 | Professional | 53 · Discontinued | $8.51 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $23.44 Typical High $36.31 | Professional | 55 · Aftercare only | $6.31 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $15.49 Typical High $23.99 | Professional | 56 · Pre-op care only | $4.27 | $15.49 | $23.99 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 51 · Multiple procedures | $29.51 | $29.51 | $29.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $81.28 Typical High $120.23 | Professional | 52 · Reduced service | $21.38 | $81.28 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $32.36 Typical High $47.86 | Professional | 53 · Discontinued | $8.51 | $32.36 | $47.86 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $24.55 Typical High $35.48 | Professional | 55 · Aftercare only | $6.31 | $24.55 | $35.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $16.22 Typical High $23.99 | Professional | 56 · Pre-op care only | $4.27 | $16.22 | $23.99 |
Where Texas sits
The same service costs 5.2 times more in North Carolina 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· 27th of 51
$182
NC $309HI $58.88
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.