How much rates vary
Facilitymedian $195 · 10th to 90th $98 to $2,818Professionalmedian $126 · 10th to 90th $55 to $1,072
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 $69.18 Median $134.90 Typical High $194.98 | Professional | None | $69.18 | $134.90 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $162.18 | Professional | None | $123.03 | $141.25 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $81.28 Median $134.90 Typical High $891.25 | Facility | None | $81.28 | $134.90 | $891.25 |
BCBS Texas Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $234.42 | Professional | None | $61.66 | $123.03 | $234.42 |
Christus Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $151.36 Typical High $1,412.54 | Facility | None | $107.15 | $151.36 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $213.80 | Professional | None | $75.86 | $138.04 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,071.52 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,258.93 Typical High $4,265.80 | Facility | None | $95.50 | $1,258.93 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $213.80 | Professional | None | $69.18 | $138.04 | $213.80 |
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 $107.15 Median $199.53 Typical High $3,801.89 | Facility | None | $107.15 | $199.53 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $213.80 | Professional | None | $75.86 | $138.04 | $213.80 |
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 $64.57 Median $112.20 Typical High $190.55 | Professional | None | $64.57 | $112.20 | $190.55 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $34.67 Median $66.07 Typical High $93.33 | Professional | 52 · Reduced service | $34.67 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $13.80 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $97.72 Typical High $138.04 | Professional | 54 · Surgery only | $51.29 | $97.72 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $19.50 Typical High $27.54 | Professional | 55 · Aftercare only | $10.23 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.18 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.92 | $13.18 | $18.62 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | GC · Resident with teaching physician | $131.83 | $131.83 | $131.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $34.67 | $67.61 | $93.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $26.92 Typical High $37.15 | Professional | 53 · Discontinued | $13.80 | $26.92 | $37.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $102.33 Typical High $138.04 | Professional | 54 · Surgery only | $51.29 | $102.33 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.42 Typical High $27.54 | Professional | 55 · Aftercare only | $10.23 | $20.42 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.80 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.92 | $13.80 | $18.62 |
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
$138
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.