How much rates vary
Facilitymedian $195 · 10th to 90th $87 to $2,818Professionalmedian $178 · 10th to 90th $35 to $490
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $190.55 | Professional | None | $112.20 | $154.88 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
BCBS Texas Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $758.58 | Facility | None | $85.11 | $117.49 | $758.58 |
BCBS Texas Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $275.42 | Professional | None | $123.03 | $173.78 | $275.42 |
Christus Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $134.90 Typical High $562.34 | Facility | None | $66.07 | $134.90 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $263.03 | Professional | None | $144.54 | $194.98 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,659.59 | $1,659.59 |
Moda Health Setting Facility Modifier None Typical Low $154.88 Median $1,258.93 Typical High $5,248.07 | Facility | None | $154.88 | $1,258.93 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $190.55 | Professional | None | $112.20 | $154.88 | $190.55 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $218.78 | Professional | None | $29.51 | $162.18 | $218.78 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $478.63 | Facility | None | $66.07 | $138.04 | $478.63 |
Providence Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $263.03 | Professional | None | $144.54 | $194.98 | $263.03 |
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 $112.20 Median $158.49 Typical High $239.88 | Professional | None | $112.20 | $158.49 | $239.88 |
Wellpoint Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $56.23 Median $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $77.62 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $30.90 | $36.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $83.18 | $114.82 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $16.60 | $23.44 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $15.49 | $18.20 |
Where Texas sits
The same service costs 3.6 times more in Alaska 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· 39th of 51
$178
AK $537KY $148
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.