How much rates vary
Facilitymedian $74 · 10th to 90th $17 to $2,291Professionalmedian $58 · 10th to 90th $41 to $437
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $100.00 | Professional | None | $46.77 | $56.23 | $100.00 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $93.33 | Professional | None | $50.12 | $50.12 | $93.33 |
BCBS Texas Setting Facility Modifier None Typical Low $27.54 Median $53.70 Typical High $354.81 | Facility | None | $27.54 | $53.70 | $354.81 |
BCBS Texas Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $74.13 | Professional | None | $42.66 | $53.70 | $74.13 |
Christus Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $36.31 Typical High $1,412.54 | Facility | None | $25.70 | $36.31 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $104.71 | Professional | None | $43.65 | $54.95 | $104.71 |
Lucent Health Setting Professional Modifier None Typical Low $436.52 Median $446.68 Typical High $446.68 | Professional | None | $436.52 | $446.68 | $446.68 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $977.24 Typical High $4,570.88 | Facility | None | $50.12 | $977.24 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $56.23 Typical High $97.72 | Professional | None | $46.77 | $56.23 | $97.72 |
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 $30.20 Median $72.44 Typical High $3,801.89 | Facility | None | $30.20 | $72.44 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $102.33 | Professional | None | $43.65 | $56.23 | $102.33 |
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 $48.98 Median $74.13 Typical High $112.20 | Professional | None | $48.98 | $74.13 | $112.20 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $51.29 | Professional | None | $50.12 | $51.29 | $51.29 |
11 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 $23.44 Median $26.30 Typical High $34.67 | Professional | 52 · Reduced service | $23.44 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $13.80 | Professional | 53 · Discontinued | $9.33 | $10.47 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $39.81 Typical High $51.29 | Professional | 54 · Surgery only | $35.48 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.94 Typical High $10.23 | Professional | 55 · Aftercare only | $7.08 | $7.94 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $6.92 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 50 · Both sides | $75.86 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $26.30 Typical High $34.67 | Professional | 52 · Reduced service | $23.44 | $26.30 | $34.67 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $13.80 | Professional | 53 · Discontinued | $9.33 | $10.47 | $13.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $39.81 Typical High $51.29 | Professional | 54 · Surgery only | $35.48 | $39.81 | $51.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.94 Typical High $10.23 | Professional | 55 · Aftercare only | $7.08 | $7.94 | $10.23 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $6.92 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $6.92 |
Where Texas sits
The same service costs 3.6 times more in Wyoming 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· 47th of 51
$58.88
WY $191FL $52.48
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.