How much rates vary
Facilitymedian $191 · 10th to 90th $46 to $2,188Professionalmedian $78 · 10th to 90th $36 to $676
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 $51.29 Median $3,311.31 Typical High $8,511.38 | Facility | None | $51.29 | $3,311.31 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $72.44 Typical High $123.03 | Professional | None | $43.65 | $72.44 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $19.50 Median $74.13 Typical High $102.33 | Professional | None | $19.50 | $74.13 | $102.33 |
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 $40.74 Median $70.79 Typical High $128.82 | Professional | None | $40.74 | $70.79 | $128.82 |
Baylor Scott & White Setting Facility Modifier None Typical Low $45.71 Median $144.54 Typical High $302.00 | Facility | None | $45.71 | $144.54 | $302.00 |
Baylor Scott & White Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Christus Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
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 $48.98 Median $81.28 Typical High $144.54 | Professional | None | $48.98 | $81.28 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | None | $676.08 | $676.08 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $52.48 Median $234.42 Typical High $3,715.35 | Facility | None | $52.48 | $234.42 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $131.83 | Professional | None | $43.65 | $75.86 | $131.83 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $70.79 Typical High $218.78 | Facility | None | $43.65 | $70.79 | $218.78 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $81.28 Typical High $144.54 | Professional | None | $48.98 | $81.28 | $144.54 |
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 $41.69 Median $70.79 Typical High $141.25 | Professional | None | $41.69 | $70.79 | $141.25 |
Wellpoint Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $21.88 Median $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $21.88 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.80 Typical High $17.38 | Professional | 53 · Discontinued | $8.71 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $52.48 Typical High $66.07 | Professional | 54 · Surgery only | $33.11 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.47 Typical High $13.18 | Professional | 55 · Aftercare only | $6.61 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.37 | $6.92 | $8.71 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | 50 · Both sides | $47.86 | $47.86 | $47.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $33.11 Typical High $43.65 | Professional | 52 · Reduced service | $21.88 | $33.11 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.18 Typical High $17.38 | Professional | 53 · Discontinued | $8.71 | $13.18 | $17.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $48.98 Typical High $66.07 | Professional | 54 · Surgery only | $33.11 | $48.98 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.77 Typical High $13.18 | Professional | 55 · Aftercare only | $6.61 | $9.77 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.61 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.37 | $6.61 | $8.71 |
Where Texas sits
The same service costs 3.3 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· 45th of 51
$81.28
AK $214KY $64.57
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.