How much rates vary
Facilitymedian $155 · 10th to 90th $60 to $2,884Professionalmedian $110 · 10th to 90th $66 to $912
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $169.82 | Professional | None | $83.18 | $120.23 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $144.54 | Professional | None | $109.65 | $117.49 | $144.54 |
BCBS Texas Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $575.44 | Facility | None | $50.12 | $85.11 | $575.44 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $194.98 | Professional | None | $74.13 | $114.82 | $194.98 |
Christus Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $1,412.54 | Facility | None | $69.18 | $97.72 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $186.21 | Professional | None | $91.20 | $128.82 | $186.21 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | None | $912.01 | $912.01 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $977.24 Typical High $4,786.30 | Facility | None | $109.65 | $977.24 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $83.18 Median $120.23 Typical High $190.55 | Professional | None | $83.18 | $120.23 | $190.55 |
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 $79.43 Median $147.91 Typical High $3,801.89 | Facility | None | $79.43 | $147.91 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $190.55 | Professional | None | $91.20 | $125.89 | $190.55 |
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 $107.15 Typical High $165.96 | Professional | None | $77.62 | $107.15 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $41.69 Median $54.95 Typical High $74.13 | Professional | 52 · Reduced service | $41.69 | $54.95 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $29.51 | Professional | 53 · Discontinued | $16.60 | $21.88 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $81.28 Typical High $112.20 | Professional | 54 · Surgery only | $63.10 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $22.39 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $14.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $56.23 Typical High $74.13 | Professional | 52 · Reduced service | $41.69 | $56.23 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.39 Typical High $29.51 | Professional | 53 · Discontinued | $16.60 | $22.39 | $29.51 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $83.18 Typical High $112.20 | Professional | 54 · Surgery only | $63.10 | $83.18 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.98 Typical High $22.39 | Professional | 55 · Aftercare only | $12.59 | $16.98 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.22 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.32 | $11.22 | $14.79 |
Where Texas sits
The same service costs 3.7 times more in Alaska 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· 48th of 51
$115
AK $372KY $100
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.