How much rates vary
Facilitymedian $195 · 10th to 90th $63 to $2,239Professionalmedian $93 · 10th to 90th $32 to $724
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 $512.86 Median $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $134.90 | Professional | None | $50.12 | $95.50 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | None | $87.10 | $97.72 | $97.72 |
BCBS Texas Setting Facility Modifier None Typical Low $57.54 Median $85.11 Typical High $537.03 | Facility | None | $57.54 | $85.11 | $537.03 |
BCBS Texas Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $177.83 | Professional | None | $48.98 | $89.13 | $177.83 |
Baylor Scott & White Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Christus Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $1,412.54 | Facility | None | $69.18 | $97.72 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $97.72 Typical High $144.54 | Professional | None | $54.95 | $97.72 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $870.96 Typical High $4,265.80 | Facility | None | $64.57 | $870.96 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $134.90 | Professional | None | $50.12 | $95.50 | $134.90 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $134.90 Typical High $3,801.89 | Facility | None | $70.79 | $134.90 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $144.54 | Professional | None | $54.95 | $100.00 | $144.54 |
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 $45.71 Median $79.43 Typical High $147.91 | Professional | None | $45.71 | $79.43 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $25.12 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $25.12 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $10.00 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $67.61 Typical High $77.62 | Professional | 54 · Surgery only | $37.15 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $7.41 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.01 | $9.12 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $25.12 | $45.71 | $52.48 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $10.00 | $18.20 | $20.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $67.61 Typical High $77.62 | Professional | 54 · Surgery only | $37.15 | $67.61 | $77.62 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $13.49 Typical High $15.49 | Professional | 55 · Aftercare only | $7.41 | $13.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.01 | $9.12 | $10.47 |
Where Texas sits
The same service costs 2.8 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· 44th of 51
$97.72
WI $257KY $91.20
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.