How much rates vary
Facilitymedian $380 · 10th to 90th $51 to $3,311Professionalmedian $71 · 10th to 90th $21 to $117
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 $77.62 Median $2,137.96 Typical High $6,760.83 | Facility | None | $77.62 | $2,137.96 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $67.61 Typical High $109.65 | Professional | None | $36.31 | $67.61 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $36.31 Typical High $77.62 | Professional | None | $18.62 | $36.31 | $77.62 |
BCBS Texas Setting Facility Modifier None Typical Low $46.77 Median $66.07 Typical High $426.58 | Facility | None | $46.77 | $66.07 | $426.58 |
BCBS Texas Setting Professional Modifier None Typical Low $36.31 Median $60.26 Typical High $107.15 | Professional | None | $36.31 | $60.26 | $107.15 |
Baylor Scott & White Setting Professional Modifier None Typical Low $38.90 Median $85.11 Typical High $128.82 | Professional | None | $38.90 | $85.11 | $128.82 |
Christus Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $77.62 Typical High $1,479.11 | Facility | None | $53.70 | $77.62 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $109.65 | Professional | None | $43.65 | $75.86 | $109.65 |
Lucent Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $933.25 Typical High $3,801.89 | Facility | None | $67.61 | $933.25 | $3,801.89 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $67.61 Typical High $109.65 | Professional | None | $36.31 | $67.61 | $109.65 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $83.18 Typical High $109.65 | Professional | None | $14.79 | $83.18 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $144.54 Typical High $302.00 | Professional | None | $138.04 | $144.54 | $302.00 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $107.15 Typical High $3,801.89 | Facility | None | $57.54 | $107.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $109.65 | Professional | None | $43.65 | $72.44 | $109.65 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $112.20 | Professional | None | $38.02 | $67.61 | $112.20 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
17 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 $18.20 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $18.20 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $7.24 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $48.98 Typical High $57.54 | Professional | 54 · Surgery only | $26.92 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $5.37 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $6.46 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.63 | $6.46 | $7.76 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $123.03 Typical High $123.03 | Professional | 50 · Both sides | $117.49 | $123.03 | $123.03 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $57.54 Median $1,548.82 Typical High $1,778.28 | Facility | 50 · Both sides | $57.54 | $1,548.82 | $1,778.28 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $691.83 Median $977.24 Typical High $4,570.88 | Facility | 59 · Distinct service | $691.83 | $977.24 | $4,570.88 |
Moda Health Setting Facility Modifier XP · Separate practitioner Typical Low $309.03 Median $758.58 Typical High $891.25 | Facility | XP · Separate practitioner | $309.03 | $758.58 | $891.25 |
Moda Health Setting Facility Modifier XU · Unusual separate service Typical Low $457.09 Median $912.01 Typical High $2,398.83 | Facility | XU · Unusual separate service | $457.09 | $912.01 | $2,398.83 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $112.20 Typical High $407.38 | Professional | 50 · Both sides | $58.88 | $112.20 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $32.36 Typical High $38.90 | Professional | 52 · Reduced service | $18.20 | $32.36 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $12.88 Typical High $15.49 | Professional | 53 · Discontinued | $7.24 | $12.88 | $15.49 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $48.98 Typical High $57.54 | Professional | 54 · Surgery only | $26.92 | $48.98 | $57.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $5.37 | $9.77 | $11.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.98 | $6.76 | $8.13 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $20.42 Median $75.86 Typical High $218.78 | Professional | 59 · Distinct service | $20.42 | $75.86 | $218.78 |
Where Texas sits
The same service costs 3.5 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· 45th of 51
$74.13
AK $204VA $58.88
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.