How much rates vary
Facilitymedian $155 · 10th to 90th $63 to $2,570Professionalmedian $123 · 10th to 90th $66 to $955
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 $81.28 Median $120.23 Typical High $165.96 | Professional | None | $81.28 | $120.23 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $588.84 | Facility | None | $53.70 | $87.10 | $588.84 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $199.53 | Professional | None | $74.13 | $112.20 | $199.53 |
Christus Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $1,412.54 | Facility | None | $74.13 | $107.15 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $194.98 | Professional | None | $91.20 | $131.83 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $1,000.00 Typical High $4,570.88 | Facility | None | $102.33 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $123.03 Typical High $181.97 | Professional | None | $81.28 | $123.03 | $181.97 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $144.54 | Professional | None | $19.50 | $107.15 | $144.54 |
Providence Setting Facility Modifier None Typical Low $85.11 Median $154.88 Typical High $3,801.89 | Facility | None | $85.11 | $154.88 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $131.83 Typical High $194.98 | Professional | None | $91.20 | $131.83 | $194.98 |
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 $77.62 Median $109.65 Typical High $173.78 | Professional | None | $77.62 | $109.65 | $173.78 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $40.74 Median $56.23 Typical High $77.62 | Professional | 52 · Reduced service | $40.74 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $22.91 Typical High $30.90 | Professional | 53 · Discontinued | $16.22 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $61.66 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $12.30 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.22 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.13 | $11.22 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $58.88 Typical High $77.62 | Professional | 52 · Reduced service | $40.74 | $58.88 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $16.22 | $23.44 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $61.66 | $87.10 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $23.44 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $23.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $11.75 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.13 | $11.75 | $15.49 |
Where Texas sits
The same service costs 3.3 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
$126
WI $372KY $112
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.