How much rates vary
Facilitymedian $1,047 · 10th to 90th $389 to $3,715Professionalmedian $316 · 10th to 90th $59 to $2,455
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 $707.95 Median $2,754.23 Typical High $6,918.31 | Facility | None | $707.95 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $436.52 | Professional | None | $186.21 | $323.59 | $436.52 |
BCBS Texas Setting Facility Modifier None Typical Low $446.68 Median $1,047.13 Typical High $2,398.83 | Facility | None | $446.68 | $1,047.13 | $2,398.83 |
BCBS Texas Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $660.69 | Professional | None | $186.21 | $323.59 | $660.69 |
Christus Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $446.68 Typical High $1,862.09 | Facility | None | $309.03 | $446.68 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $467.74 | Professional | None | $204.17 | $331.13 | $467.74 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,454.71 | $2,454.71 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $234.42 Median $1,148.15 Typical High $4,786.30 | Facility | None | $234.42 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $436.52 | Professional | None | $186.21 | $316.23 | $436.52 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $269.15 Typical High $363.08 | Professional | None | $48.98 | $269.15 | $363.08 |
Providence Setting Facility Modifier None Typical Low $316.23 Median $512.86 Typical High $4,466.84 | Facility | None | $316.23 | $512.86 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $467.74 | Professional | None | $204.17 | $331.13 | $467.74 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,801.89 | Facility | None | $616.60 | $1,995.26 | $3,801.89 |
United Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $426.58 | Professional | None | $169.82 | $269.15 | $426.58 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
11 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 $93.33 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $93.33 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $37.15 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $141.25 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $28.18 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.62 | $32.36 | $38.02 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 51 · Multiple procedures | $89.13 | $89.13 | $89.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $93.33 | $165.96 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $37.15 | $66.07 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $141.25 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $28.18 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.62 | $33.11 | $38.02 |
Where Texas sits
The same service costs 3.0 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· 34th of 51
$363
WI $891KY $295
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.