How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,202 to $6,918Professionalmedian $105 · 10th to 90th $22 to $1,514
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 $81.28 Median $81.28 Typical High $128.82 | Facility | None | $81.28 | $81.28 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $134.90 | Professional | None | $79.43 | $100.00 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $134.90 | Professional | None | $102.33 | $112.20 | $134.90 |
BCBS Texas Setting Facility Modifier None Typical Low $2,290.87 Median $4,168.69 Typical High $9,120.11 | Facility | None | $2,290.87 | $4,168.69 | $9,120.11 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $194.98 | Professional | None | $74.13 | $91.20 | $194.98 |
Christus Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,995.26 Typical High $2,818.38 | Facility | None | $489.78 | $1,995.26 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $177.83 | Professional | None | $95.50 | $107.15 | $177.83 |
Lucent Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,698.24 Typical High $3,715.35 | Facility | None | $95.50 | $1,698.24 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $151.36 | Professional | None | $79.43 | $100.00 | $151.36 |
Molina Setting Professional Modifier None Typical Low $19.05 Median $104.71 Typical High $144.54 | Professional | None | $19.05 | $104.71 | $144.54 |
Providence Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $169.82 | Facility | None | $91.20 | $109.65 | $169.82 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $162.18 Typical High $316.23 | Professional | None | $60.26 | $162.18 | $316.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $169.82 | Professional | None | $81.28 | $112.20 | $169.82 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
8 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 $39.81 Median $44.67 Typical High $50.12 | Professional | 52 · Reduced service | $39.81 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $15.85 | $17.78 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.49 Typical High $15.14 | Professional | 55 · Aftercare only | $12.02 | $13.49 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $44.67 Typical High $51.29 | Professional | 52 · Reduced service | $39.81 | $44.67 | $51.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $17.78 Typical High $20.42 | Professional | 53 · Discontinued | $15.85 | $17.78 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $15.14 | Professional | 55 · Aftercare only | $11.75 | $13.18 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.91 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.94 | $8.91 | $10.00 |
Where Texas sits
The same service costs 7.9 times more in Kansas than in New York. 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
$120
KS $832NY $105
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.