How much rates vary
Facilitymedian $138 · 10th to 90th $50 to $2,188Professionalmedian $68 · 10th to 90th $15 to $537
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 $87.10 Median $3,715.35 Typical High $9,120.11 | Facility | None | $87.10 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $89.13 | Professional | None | $41.69 | $67.61 | $89.13 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $72.44 | Professional | None | $66.07 | $67.61 | $72.44 |
BCBS Texas Setting Facility Modifier None Typical Low $66.07 Median $151.36 Typical High $758.58 | Facility | None | $66.07 | $151.36 | $758.58 |
BCBS Texas Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $117.49 | Professional | None | $43.65 | $70.79 | $117.49 |
Baylor Scott & White Setting Facility Modifier None Typical Low $45.71 Median $158.49 Typical High $281.84 | Facility | None | $45.71 | $158.49 | $281.84 |
Baylor Scott & White Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Christus Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $89.13 | Facility | None | $36.31 | $50.12 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $112.20 | Professional | None | $46.77 | $74.13 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $602.56 | Professional | None | $537.03 | $537.03 | $602.56 |
Moda Health Setting Facility Modifier None Typical Low $42.66 Median $269.15 Typical High $5,128.61 | Facility | None | $42.66 | $269.15 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $102.33 | Professional | None | $41.69 | $70.79 | $102.33 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $72.44 | Professional | None | $9.77 | $53.70 | $72.44 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $104.71 | Facility | None | $39.81 | $52.48 | $104.71 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $112.20 | Professional | None | $46.77 | $74.13 | $112.20 |
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 $39.81 Median $63.10 Typical High $102.33 | Professional | None | $39.81 | $63.10 | $102.33 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $20.89 Median $31.62 Typical High $43.65 | Professional | 52 · Reduced service | $20.89 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.88 Typical High $17.38 | Professional | 53 · Discontinued | $8.32 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $47.86 Typical High $66.07 | Professional | 54 · Surgery only | $31.62 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.55 Typical High $13.18 | Professional | 55 · Aftercare only | $6.31 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.17 | $6.46 | $8.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 59 · Distinct service | $67.61 | $67.61 | $67.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $32.36 Typical High $43.65 | Professional | 52 · Reduced service | $20.89 | $32.36 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.88 Typical High $17.38 | Professional | 53 · Discontinued | $8.32 | $12.88 | $17.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $48.98 Typical High $66.07 | Professional | 54 · Surgery only | $31.62 | $48.98 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $6.31 | $9.77 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.46 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.17 | $6.46 | $8.71 |
Where Texas sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 42nd of 51
$70.79
WI $200DC $64.57
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.