How much rates vary
Facilitymedian $102 · 10th to 90th $52 to $2,884Professionalmedian $93 · 10th to 90th $45 to $759
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $131.83 | Professional | None | $60.26 | $93.33 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $93.33 Typical High $102.33 | Professional | None | $57.54 | $93.33 | $102.33 |
BCBS Texas Setting Facility Modifier None Typical Low $41.69 Median $64.57 Typical High $436.52 | Facility | None | $41.69 | $64.57 | $436.52 |
BCBS Texas Setting Professional Modifier None Typical Low $53.70 Median $85.11 Typical High $158.49 | Professional | None | $53.70 | $85.11 | $158.49 |
Christus Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $85.11 Typical High $1,412.54 | Facility | None | $60.26 | $85.11 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $147.91 | Professional | None | $66.07 | $102.33 | $147.91 |
Lucent Health Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | None | $758.58 | $758.58 | $912.01 |
Moda Health Setting Facility Modifier None Typical Low $79.43 Median $1,230.27 Typical High $5,248.07 | Facility | None | $79.43 | $1,230.27 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $93.33 Typical High $141.25 | Professional | None | $60.26 | $93.33 | $141.25 |
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 $66.07 Median $123.03 Typical High $3,801.89 | Facility | None | $66.07 | $123.03 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $102.33 Typical High $147.91 | Professional | None | $66.07 | $102.33 | $147.91 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,090.30 | Facility | None | $389.05 | $1,288.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $131.83 | Professional | None | $56.23 | $81.28 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $30.20 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $30.20 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.78 Typical High $24.55 | Professional | 53 · Discontinued | $12.02 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $44.67 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $9.12 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.91 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.03 | $8.91 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $44.67 Typical High $60.26 | Professional | 52 · Reduced service | $30.20 | $44.67 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $18.20 Typical High $24.55 | Professional | 53 · Discontinued | $12.02 | $18.20 | $24.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $67.61 Typical High $91.20 | Professional | 54 · Surgery only | $44.67 | $67.61 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $9.12 | $13.49 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.91 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.03 | $8.91 | $12.30 |
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· 44th of 51
$97.72
WI $282KY $77.62
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.