How much rates vary
Facilitymedian $240 · 10th to 90th $55 to $661Professionalmedian $35 · 10th to 90th $29 to $74
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 $33.88 Median $37.15 Typical High $46.77 | Facility | None | $33.88 | $37.15 | $46.77 |
Aetna Setting Professional Modifier None (both parts) Typical Low $28.84 Median $35.48 Typical High $46.77 | Professional | None (both parts) | $28.84 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $17.78 Typical High $22.91 | Professional | 52 · Reduced service | $14.45 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.08 Typical High $9.33 | Professional | 53 · Discontinued | $5.75 | $7.08 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.27 | $5.37 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $4.68 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $27.54 Median $37.15 Typical High $43.65 | Professional | None (both parts) | $27.54 | $37.15 | $43.65 |
BCBS Texas Setting Facility Modifier None Typical Low $173.78 Median $407.38 Typical High $741.31 | Facility | None | $173.78 | $407.38 | $741.31 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $26.92 Median $32.36 Typical High $35.48 | Professional | None (both parts) | $26.92 | $32.36 | $35.48 |
Baylor Scott & White Setting Facility Modifier None Typical Low $213.80 Median $218.78 Typical High $407.38 | Facility | None | $213.80 | $218.78 | $407.38 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $43.65 Median $66.07 Typical High $102.33 | Professional | None (both parts) | $43.65 | $66.07 | $102.33 |
Christus Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $97.72 Typical High $257.04 | Facility | None | $38.02 | $97.72 | $257.04 |
Cigna Setting Professional Modifier None (both parts) Typical Low $34.67 Median $40.74 Typical High $43.65 | Professional | None (both parts) | $34.67 | $40.74 | $43.65 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $288.40 Median $288.40 Typical High $363.08 | Professional | None (both parts) | $288.40 | $288.40 | $363.08 |
Moda Health Setting Facility Modifier None Typical Low $34.67 Median $60.26 Typical High $323.59 | Facility | None | $34.67 | $60.26 | $323.59 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $28.84 Median $35.48 Typical High $46.77 | Professional | None (both parts) | $28.84 | $35.48 | $46.77 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $17.78 Typical High $22.91 | Professional | 52 · Reduced service | $14.45 | $17.78 | $22.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.08 Typical High $9.33 | Professional | 53 · Discontinued | $5.75 | $7.08 | $9.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.37 Typical High $6.92 | Professional | 55 · Aftercare only | $4.27 | $5.37 | $6.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $4.68 |
Molina Setting Professional Modifier None (both parts) Typical Low $10.47 Median $58.88 Typical High $72.44 | Professional | None (both parts) | $10.47 | $58.88 | $72.44 |
Oscar Health Setting Professional Modifier None (both parts) Typical Low $31.62 Median $69.18 Typical High $151.36 | Professional | None (both parts) | $31.62 | $69.18 | $151.36 |
Providence Setting Facility Modifier None Typical Low $34.67 Median $50.12 Typical High $134.90 | Facility | None | $34.67 | $50.12 | $134.90 |
Providence Setting Professional Modifier None (both parts) Typical Low $34.67 Median $40.74 Typical High $43.65 | Professional | None (both parts) | $34.67 | $40.74 | $43.65 |
United Setting Facility Modifier None Typical Low $323.59 Median $338.84 Typical High $446.68 | Facility | None | $323.59 | $338.84 | $446.68 |
United Setting Professional Modifier None (both parts) Typical Low $29.51 Median $38.02 Typical High $52.48 | Professional | None (both parts) | $29.51 | $38.02 | $52.48 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None (both parts) | $42.66 | $42.66 | $42.66 |
1 more rate 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 |
|---|---|---|---|---|---|
Christus Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 26 · Professional part | $20.42 | $20.42 | $20.42 |
Where Texas sits
The same service costs 2.9 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· 47th of 51
$37.15
AK $100KY $34.67
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.