How much rates vary
Facilitymedian $186 · 10th to 90th $56 to $2,188Professionalmedian $62 · 10th to 90th $40 to $98
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 $74.13 Median $3,715.35 Typical High $8,709.64 | Facility | None | $74.13 | $3,715.35 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $93.33 | Professional | None | $50.12 | $69.18 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $64.57 | Professional | None | $43.65 | $60.26 | $64.57 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $1,513.56 | Facility | None | $95.50 | $190.55 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $85.11 | Professional | None | $39.81 | $58.88 | $85.11 |
Christus Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $91.20 | Professional | None | $46.77 | $63.10 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $51.29 Median $371.54 Typical High $4,365.16 | Facility | None | $51.29 | $371.54 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $93.33 | Professional | None | $50.12 | $69.18 | $93.33 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $53.70 Typical High $74.13 | Professional | None | $10.00 | $53.70 | $74.13 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $151.36 | Facility | None | $48.98 | $67.61 | $151.36 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $91.20 | Professional | None | $46.77 | $63.10 | $91.20 |
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 $44.67 Median $60.26 Typical High $91.20 | Professional | None | $44.67 | $60.26 | $91.20 |
Wellpoint Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | None | $64.57 | $66.07 | $66.07 |
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 $25.12 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $25.12 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $10.00 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $51.29 Typical High $63.10 | Professional | 54 · Surgery only | $38.02 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.23 Typical High $12.59 | Professional | 55 · Aftercare only | $7.59 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.01 | $6.92 | $8.32 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $25.12 | $34.67 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $10.00 | $13.80 | $16.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $51.29 Typical High $63.10 | Professional | 54 · Surgery only | $38.02 | $51.29 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.23 Typical High $12.59 | Professional | 55 · Aftercare only | $7.59 | $10.23 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $5.01 | $6.92 | $8.32 |
Where Texas sits
The same service costs 3.6 times more in Alaska than in Florida. 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· 43rd of 51
$64.57
AK $200FL $54.95
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.