How much rates vary
Facilitymedian $380 · 10th to 90th $110 to $3,548Professionalmedian $145 · 10th to 90th $29 to $1,148
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $204.17 | Professional | None | $69.18 | $158.49 | $204.17 |
BCBS Texas Setting Facility Modifier None Typical Low $77.62 Median $147.91 Typical High $794.33 | Facility | None | $77.62 | $147.91 | $794.33 |
BCBS Texas Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $169.82 | Professional | None | $57.54 | $109.65 | $169.82 |
Christus Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $1,412.54 | Facility | None | $117.49 | $169.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $134.90 Typical High $194.98 | Professional | None | $74.13 | $134.90 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | None | $1,148.15 | $1,148.15 | $1,445.44 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $1,000.00 Typical High $4,677.35 | Facility | None | $75.86 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $204.17 | Professional | None | $69.18 | $158.49 | $204.17 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $131.83 Typical High $181.97 | Professional | None | $23.99 | $131.83 | $181.97 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $208.93 Typical High $3,801.89 | Facility | None | $117.49 | $208.93 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $199.53 | Professional | None | $75.86 | $134.90 | $199.53 |
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 $61.66 Median $107.15 Typical High $177.83 | Professional | None | $61.66 | $107.15 | $177.83 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $34.67 Median $72.44 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $13.80 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $109.65 Typical High $134.90 | Professional | 54 · Surgery only | $52.48 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $10.47 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $14.45 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $14.45 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $75.86 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $75.86 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $30.20 Typical High $35.48 | Professional | 53 · Discontinued | $13.80 | $30.20 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $112.20 Typical High $134.90 | Professional | 54 · Surgery only | $52.48 | $112.20 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $22.39 Typical High $26.92 | Professional | 55 · Aftercare only | $10.47 | $22.39 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $15.14 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $15.14 | $17.78 |
Where Texas sits
The same service costs 3.6 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· 22nd of 51
$158
WI $380KY $105
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.