How much rates vary
Facilitymedian $288 · 10th to 90th $107 to $550Professionalmedian $100 · 10th to 90th $85 to $102
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | None | $87.10 | $102.33 | $102.33 |
BCBS Texas Setting Facility Modifier None Typical Low $120.23 Median $295.12 Typical High $549.54 | Facility | None | $120.23 | $295.12 | $549.54 |
BCBS Texas Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $302.00 | Facility | None | $95.50 | $144.54 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $204.17 | Facility | None | $102.33 | $102.33 | $204.17 |
Moda Health Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | None | $87.10 | $102.33 | $102.33 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $812.83 | Facility | None | $95.50 | $114.82 | $812.83 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $131.83 | Professional | None | $81.28 | $100.00 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
8 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 $43.65 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $17.38 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $10.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where Texas sits
The same service costs 1.7 times more in Texas than in Arkansas. 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· 1st of 51
$148
TX $148AR $85.11
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.