How much rates vary
Facilitymedian $316 · 10th to 90th $49 to $2,042Professionalmedian $74 · 10th to 90th $46 to $562
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 $83.18 Median $3,715.35 Typical High $9,120.11 | Facility | None | $83.18 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $93.33 | Professional | None | $61.66 | $75.86 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $42.66 Median $323.59 Typical High $1,071.52 | Facility | None | $42.66 | $323.59 | $1,071.52 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $114.82 | Professional | None | $58.88 | $74.13 | $114.82 |
Christus Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $91.20 | Facility | None | $37.15 | $50.12 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $74.13 Typical High $97.72 | Professional | None | $61.66 | $74.13 | $97.72 |
Lucent Health Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Professional | None | $562.34 | $562.34 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $61.66 Median $707.95 Typical High $5,248.07 | Facility | None | $61.66 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $93.33 | Professional | None | $61.66 | $75.86 | $93.33 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $54.95 Typical High $74.13 | Professional | None | $10.00 | $54.95 | $74.13 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $56.23 Typical High $114.82 | Facility | None | $42.66 | $56.23 | $114.82 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $97.72 | Professional | None | $61.66 | $75.86 | $97.72 |
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 $54.95 Median $72.44 Typical High $104.71 | Professional | None | $54.95 | $72.44 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $79.43 | Professional | None | $75.86 | $79.43 | $79.43 |
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 $30.90 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $30.90 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.14 Typical High $18.62 | Professional | 53 · Discontinued | $12.59 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $57.54 Typical High $69.18 | Professional | 54 · Surgery only | $46.77 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $9.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $30.90 | $38.02 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $15.14 Typical High $18.62 | Professional | 53 · Discontinued | $12.59 | $15.14 | $18.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $57.54 Typical High $69.18 | Professional | 54 · Surgery only | $46.77 | $57.54 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $9.33 |
Where Texas sits
The same service costs 3.8 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· 39th of 51
$75.86
AK $257FL $67.61
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.