How much rates vary
Facilitymedian $251 · 10th to 90th $100 to $3,236Professionalmedian $72 · 10th to 90th $13 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 $85.11 Median $3,715.35 Typical High $9,120.11 | Facility | None | $85.11 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $109.65 | Professional | None | $46.77 | $69.18 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $75.86 | Professional | None | $43.65 | $75.86 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $144.54 Median $302.00 Typical High $3,467.37 | Facility | None | $144.54 | $302.00 | $3,467.37 |
BCBS Texas Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $190.55 | Professional | None | $48.98 | $77.62 | $190.55 |
Baylor Scott & White Setting Facility Modifier None Typical Low $48.98 Median $213.80 Typical High $281.84 | Facility | None | $48.98 | $213.80 | $281.84 |
Baylor Scott & White Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Christus Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
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 $52.48 Median $79.43 Typical High $154.88 | Professional | None | $52.48 | $79.43 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $239.88 Typical High $4,786.30 | Facility | None | $50.12 | $239.88 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $117.49 | Professional | None | $46.77 | $72.44 | $117.49 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $72.44 | Professional | None | $9.77 | $53.70 | $72.44 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $70.79 Typical High $223.87 | Facility | None | $46.77 | $70.79 | $223.87 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $151.36 | Professional | None | $52.48 | $79.43 | $151.36 |
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 $75.86 Typical High $147.91 | Professional | None | $44.67 | $75.86 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $23.44 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $23.44 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.49 Typical High $16.98 | Professional | 53 · Discontinued | $9.33 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $50.12 Typical High $63.10 | Professional | 54 · Surgery only | $35.48 | $50.12 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.00 Typical High $12.59 | Professional | 55 · Aftercare only | $7.08 | $10.00 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.68 | $6.76 | $8.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $33.11 Typical High $42.66 | Professional | 52 · Reduced service | $23.44 | $33.11 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.18 Typical High $16.98 | Professional | 53 · Discontinued | $9.33 | $13.18 | $16.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $48.98 Typical High $63.10 | Professional | 54 · Surgery only | $35.48 | $48.98 | $63.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.77 Typical High $12.59 | Professional | 55 · Aftercare only | $7.08 | $9.77 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.61 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.68 | $6.61 | $8.51 |
Where Texas sits
The same service costs 3.2 times more in Wisconsin 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· 48th of 51
$77.62
WI $229KY $72.44
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.