How much rates vary
Facilitymedian $145 · 10th to 90th $18 to $2,455Professionalmedian $18 · 10th to 90th $6 to $112
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 $13.18 Median $14.45 Typical High $24.55 | Professional | None | $13.18 | $14.45 | $24.55 |
Ambetter Setting Professional Modifier None Typical Low $12.88 Median $15.14 Typical High $18.62 | Professional | None | $12.88 | $15.14 | $18.62 |
BCBS Texas Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $1,513.56 | Facility | None | $56.23 | $100.00 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $24.55 | Professional | None | $12.88 | $16.60 | $24.55 |
Baylor Scott & White Setting Professional Modifier None Typical Low $16.22 Median $19.50 Typical High $25.70 | Professional | None | $16.22 | $19.50 | $25.70 |
Christus Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $537.03 Typical High $1,348.96 | Facility | None | $66.07 | $537.03 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $21.38 | Professional | None | $14.45 | $17.38 | $21.38 |
Lucent Health Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | None | $112.20 | $147.91 | $147.91 |
Moda Health Setting Facility Modifier None Typical Low $20.42 Median $467.74 Typical High $4,168.69 | Facility | None | $20.42 | $467.74 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $13.18 Median $14.79 Typical High $29.51 | Professional | None | $13.18 | $14.79 | $29.51 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $26.30 Typical High $36.31 | Professional | None | $4.79 | $26.30 | $36.31 |
Oscar Health Setting Facility Modifier None Typical Low $39.81 Median $489.78 Typical High $489.78 | Facility | None | $39.81 | $489.78 | $489.78 |
Providence Setting Facility Modifier None Typical Low $16.22 Median $66.07 Typical High $954.99 | Facility | None | $16.22 | $66.07 | $954.99 |
Providence Setting Professional Modifier None Typical Low $14.45 Median $17.38 Typical High $22.39 | Professional | None | $14.45 | $17.38 | $22.39 |
United Setting Facility Modifier None Typical Low $138.04 Median $741.31 Typical High $2,187.76 | Facility | None | $138.04 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $10.72 Median $14.45 Typical High $21.38 | Professional | None | $10.72 | $14.45 | $21.38 |
Wellpoint Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
14 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 $6.92 Median $7.24 Typical High $8.32 | Professional | 52 · Reduced service | $6.92 | $7.24 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.88 Typical High $3.31 | Professional | 53 · Discontinued | $2.75 | $2.88 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $10.96 Typical High $12.59 | Professional | 54 · Surgery only | $10.47 | $10.96 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.09 Median $2.19 Typical High $2.51 | Professional | 55 · Aftercare only | $2.09 | $2.19 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.45 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.38 | $1.45 | $1.66 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $17.78 Median $21.88 Typical High $25.70 | Professional | 50 · Both sides | $17.78 | $21.88 | $25.70 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $15.14 Median $16.22 Typical High $16.98 | Professional | 59 · Distinct service | $15.14 | $16.22 | $16.98 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $56.23 Median $147.91 Typical High $251.19 | Facility | 50 · Both sides | $56.23 | $147.91 | $251.19 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $9.77 Median $34.67 Typical High $85.11 | Professional | 50 · Both sides | $9.77 | $34.67 | $85.11 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $7.24 Typical High $8.32 | Professional | 52 · Reduced service | $6.92 | $7.24 | $8.32 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $2.88 Typical High $3.31 | Professional | 53 · Discontinued | $2.75 | $2.88 | $3.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $10.96 Typical High $12.59 | Professional | 54 · Surgery only | $10.23 | $10.96 | $12.59 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.19 Typical High $2.51 | Professional | 55 · Aftercare only | $2.04 | $2.19 | $2.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $1.45 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.38 | $1.45 | $1.66 |
Where Texas sits
The same service costs 7.4 times more in Kansas 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· 28th of 51
$21.88
KS $95.50KY $12.88
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.