How much rates vary
Facilitymedian $182 · 10th to 90th $74 to $2,570Professionalmedian $141 · 10th to 90th $26 to $1,096
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 $512.86 Median $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $141.25 Typical High $208.93 | Professional | None | $93.33 | $141.25 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $162.18 | Professional | None | $131.83 | $144.54 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $63.10 Median $102.33 Typical High $691.83 | Facility | None | $63.10 | $102.33 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $239.88 | Professional | None | $95.50 | $147.91 | $239.88 |
Baylor Scott & White Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Christus Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $114.82 Typical High $1,412.54 | Facility | None | $79.43 | $114.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $223.87 | Professional | None | $100.00 | $151.36 | $223.87 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,096.48 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $870.96 Typical High $4,570.88 | Facility | None | $125.89 | $870.96 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $218.78 | Professional | None | $93.33 | $144.54 | $218.78 |
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 $91.20 Median $169.82 Typical High $3,801.89 | Facility | None | $91.20 | $169.82 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $223.87 | Professional | None | $100.00 | $151.36 | $223.87 |
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 $87.10 Median $125.89 Typical High $199.53 | Professional | None | $87.10 | $125.89 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $46.77 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $46.77 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $18.62 | $26.30 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $97.72 Typical High $134.90 | Professional | 54 · Surgery only | $69.18 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.50 Typical High $26.92 | Professional | 55 · Aftercare only | $13.80 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $46.77 | $66.07 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $26.30 Typical High $35.48 | Professional | 53 · Discontinued | $18.62 | $26.30 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $69.18 | $100.00 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $13.80 | $19.95 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $9.33 | $13.18 | $17.78 |
Where Texas sits
The same service costs 3.2 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
$141
WI $417KY $129
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.