How much rates vary
Facilitymedian $275 · 10th to 90th $148 to $708Professionalmedian $251 · 10th to 90th $229 to $269
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 $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $295.12 | Professional | None | $229.09 | $269.15 | $295.12 |
BCBS Texas Setting Facility Modifier None Typical Low $177.83 Median $436.52 Typical High $831.76 | Facility | None | $177.83 | $436.52 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Christus Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $380.19 Typical High $812.83 | Facility | None | $251.19 | $380.19 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Moda Health Setting Facility Modifier None Typical Low $128.82 Median $269.15 Typical High $407.38 | Facility | None | $128.82 | $269.15 | $407.38 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $281.84 | Professional | None | $229.09 | $269.15 | $281.84 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $223.87 | Professional | None | $30.20 | $30.20 | $223.87 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $302.00 Typical High $2,187.76 | Facility | None | $251.19 | $302.00 | $2,187.76 |
Providence Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $269.15 | Professional | None | $213.80 | $269.15 | $269.15 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $114.82 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $114.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $34.67 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $26.92 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $134.90 | $134.90 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $53.70 | $53.70 | $53.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $26.92 |
Where Texas sits
The same service costs 2.0 times more in Arizona than in Alabama. 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· 27th of 51
$251
AZ $324AL $162
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.