How much rates vary
Facilitymedian $95 · 10th to 90th $52 to $2,089Professionalmedian $95 · 10th to 90th $50 to $724
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 $426.58 Median $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $134.90 | Professional | None | $58.88 | $95.50 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $81.28 Typical High $107.15 | Professional | None | $66.07 | $81.28 | $107.15 |
BCBS Texas Setting Facility Modifier None Typical Low $48.98 Median $72.44 Typical High $478.63 | Facility | None | $48.98 | $72.44 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $162.18 | Professional | None | $51.29 | $87.10 | $162.18 |
Baylor Scott & White Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $169.82 | Professional | None | $89.13 | $109.65 | $169.82 |
Christus Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $123.03 | Facility | None | $50.12 | $66.07 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $165.96 | Professional | None | $63.10 | $100.00 | $165.96 |
Health Smart Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | None | $724.44 | $724.44 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $707.95 Typical High $4,168.69 | Facility | None | $87.10 | $707.95 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $162.18 | Professional | None | $58.88 | $97.72 | $162.18 |
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 $53.70 Median $69.18 Typical High $141.25 | Facility | None | $53.70 | $69.18 | $141.25 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $165.96 | Professional | None | $63.10 | $100.00 | $165.96 |
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 $61.66 Median $97.72 Typical High $147.91 | Professional | None | $61.66 | $97.72 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
13 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 $28.84 Median $43.65 Typical High $60.26 | Professional | 52 · Reduced service | $28.84 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.38 Typical High $23.99 | Professional | 53 · Discontinued | $11.75 | $17.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $66.07 Typical High $91.20 | Professional | 54 · Surgery only | $43.65 | $66.07 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.18 Typical High $18.20 | Professional | 55 · Aftercare only | $8.71 | $13.18 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.71 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.75 | $8.71 | $12.02 |
Ambetter Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $91.20 | $95.50 | $104.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 59 · Distinct service | $87.10 | $87.10 | $95.50 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $64.57 Median $87.10 Typical High $87.10 | Professional | GC · Resident with teaching physician | $64.57 | $87.10 | $87.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $45.71 Typical High $60.26 | Professional | 52 · Reduced service | $28.84 | $45.71 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $18.20 Typical High $23.99 | Professional | 53 · Discontinued | $11.75 | $18.20 | $23.99 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $67.61 Typical High $91.20 | Professional | 54 · Surgery only | $43.65 | $67.61 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $13.49 Typical High $18.20 | Professional | 55 · Aftercare only | $8.71 | $13.49 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $9.12 Typical High $12.02 | Professional | 56 · Pre-op care only | $5.75 | $9.12 | $12.02 |
Where Texas sits
The same service costs 3.0 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· 48th of 51
$95.50
WI $282KY $93.33
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.