How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,047 to $6,761Professionalmedian $550 · 10th to 90th $65 to $3,467
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 $851.14 Median $2,570.40 Typical High $6,918.31 | Facility | None | $851.14 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $1,659.59 Typical High $2,187.76 | Professional | None | $371.54 | $1,659.59 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $3,890.45 | Professional | None | $346.74 | $346.74 | $3,890.45 |
BCBS Texas Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $6,760.83 | Facility | None | $1,000.00 | $1,995.26 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $363.08 Median $1,412.54 Typical High $2,511.89 | Professional | None | $363.08 | $1,412.54 | $2,511.89 |
Christus Setting Facility Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Facility | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $4,570.88 | Facility | None | $758.58 | $2,187.76 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $1,258.93 Typical High $2,570.40 | Professional | None | $398.11 | $1,258.93 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $17,782.79 Median $29,512.09 Typical High $29,512.09 | Professional | None | $17,782.79 | $29,512.09 | $29,512.09 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $2,570.40 Typical High $8,511.38 | Facility | None | $537.03 | $2,570.40 | $8,511.38 |
Moda Health Setting Professional Modifier None Typical Low $371.54 Median $1,584.89 Typical High $2,290.87 | Professional | None | $371.54 | $1,584.89 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $51.29 Median $489.78 Typical High $3,162.28 | Professional | None | $51.29 | $489.78 | $3,162.28 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,511.89 Typical High $11,748.98 | Facility | None | $630.96 | $2,511.89 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $398.11 Median $1,258.93 Typical High $2,570.40 | Professional | None | $398.11 | $1,258.93 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,047.13 Typical High $2,630.27 | Professional | None | $331.13 | $1,047.13 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $186.21 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $186.21 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $74.13 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,148.15 Typical High $1,412.54 | Professional | 54 · Surgery only | $275.42 | $1,148.15 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $56.23 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $37.15 | $151.36 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $186.21 | $758.58 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $74.13 | $302.00 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,148.15 Typical High $1,412.54 | Professional | 54 · Surgery only | $275.42 | $1,148.15 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $229.09 Typical High $281.84 | Professional | 55 · Aftercare only | $56.23 | $229.09 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $37.15 | $151.36 | $186.21 |
Where Texas sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 46th of 51
$1,349
IA $2,692NE $741
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.