How much rates vary
Facilitymedian $1,862 · 10th to 90th $631 to $4,571Professionalmedian $224 · 10th to 90th $48 to $2,089
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $208.93 Typical High $281.84 | Professional | None | $102.33 | $208.93 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $154.88 | Professional | None | $123.03 | $154.88 | $154.88 |
BCBS Texas Setting Facility Modifier None Typical Low $933.25 Median $2,089.30 Typical High $4,073.80 | Facility | None | $933.25 | $2,089.30 | $4,073.80 |
BCBS Texas Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $380.19 | Professional | None | $112.20 | $194.98 | $380.19 |
Christus Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Facility | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $371.54 | Professional | None | $123.03 | $234.42 | $371.54 |
Health Smart Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,089.30 | $2,630.27 |
Moda Health Setting Facility Modifier None Typical Low $269.15 Median $1,905.46 Typical High $5,370.32 | Facility | None | $269.15 | $1,905.46 | $5,370.32 |
Moda Health Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $288.40 | Professional | None | $102.33 | $213.80 | $288.40 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $199.53 Typical High $251.19 | Professional | None | $34.67 | $199.53 | $251.19 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $6,025.60 Typical High $10,715.19 | Facility | None | $165.96 | $6,025.60 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $371.54 | Professional | None | $123.03 | $234.42 | $371.54 |
United Setting Facility Modifier None Typical Low $446.68 Median $2,187.76 Typical High $3,801.89 | Facility | None | $446.68 | $2,187.76 | $3,801.89 |
United Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $371.54 | Professional | None | $112.20 | $213.80 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $51.29 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $51.29 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $20.42 | $39.81 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $147.91 Typical High $208.93 | Professional | 54 · Surgery only | $75.86 | $147.91 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $30.20 Typical High $41.69 | Professional | 55 · Aftercare only | $15.49 | $30.20 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.23 | $19.95 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $102.33 Typical High $138.04 | Professional | 52 · Reduced service | $51.29 | $102.33 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $20.42 | $39.81 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $151.36 Typical High $208.93 | Professional | 54 · Surgery only | $75.86 | $151.36 | $208.93 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $30.90 Typical High $41.69 | Professional | 55 · Aftercare only | $15.49 | $30.90 | $41.69 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.23 | $19.95 | $27.54 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 36th of 51
$234
AK $525VA $155
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.