How much rates vary
Facilitymedian $302 · 10th to 90th $85 to $2,884Professionalmedian $166 · 10th to 90th $32 to $1,288
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 $112.20 Median $165.96 Typical High $245.47 | Professional | None | $112.20 | $165.96 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $173.78 | Professional | None | $158.49 | $169.82 | $173.78 |
BCBS Texas Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $776.25 | Facility | None | $69.18 | $114.82 | $776.25 |
BCBS Texas Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $281.84 | Professional | None | $114.82 | $173.78 | $281.84 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $138.04 Typical High $1,412.54 | Facility | None | $95.50 | $138.04 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $257.04 | Professional | None | $123.03 | $177.83 | $257.04 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,288.25 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $141.25 Median $1,000.00 Typical High $4,570.88 | Facility | None | $141.25 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $251.19 | Professional | None | $112.20 | $165.96 | $251.19 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $134.90 Typical High $181.97 | Professional | None | $24.55 | $134.90 | $181.97 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $3,801.89 | Facility | None | $109.65 | $204.17 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $263.03 | Professional | None | $123.03 | $177.83 | $263.03 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,235.94 | Facility | None | $389.05 | $1,288.25 | $3,235.94 |
United Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $234.42 | Professional | None | $104.71 | $147.91 | $234.42 |
Wellpoint Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $56.23 Median $75.86 Typical High $104.71 | Professional | 52 · Reduced service | $56.23 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $154.88 | Professional | 54 · Surgery only | $83.18 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $30.90 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $77.62 Typical High $104.71 | Professional | 52 · Reduced service | $56.23 | $77.62 | $104.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $31.62 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $31.62 | $41.69 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $117.49 Typical High $154.88 | Professional | 54 · Surgery only | $83.18 | $117.49 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $30.90 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $20.89 |
Where Texas sits
The same service costs 3.7 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· 47th of 51
$170
WI $501KY $135
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.