How much rates vary
Facilitymedian $372 · 10th to 90th $87 to $2,399Professionalmedian $138 · 10th to 90th $30 to $316
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 $53.70 Median $131.83 Typical High $218.78 | Professional | None | $53.70 | $131.83 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $141.25 Typical High $154.88 | Professional | None | $134.90 | $141.25 | $154.88 |
BCBS Texas Setting Facility Modifier None Typical Low $87.10 Median $323.59 Typical High $831.76 | Facility | None | $87.10 | $323.59 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $263.03 | Professional | None | $52.48 | $131.83 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $158.49 Typical High $229.09 | Facility | None | $67.61 | $158.49 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $239.88 | Professional | None | $57.54 | $123.03 | $239.88 |
Lucent Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,230.27 | $1,230.27 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $1,047.13 Typical High $4,786.30 | Facility | None | $74.13 | $1,047.13 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $131.83 Typical High $223.87 | Professional | None | $53.70 | $131.83 | $223.87 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $131.83 Typical High $181.97 | Professional | None | $24.55 | $131.83 | $181.97 |
Providence Setting Facility Modifier None Typical Low $46.77 Median $141.25 Typical High $229.09 | Facility | None | $46.77 | $141.25 | $229.09 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $239.88 | Professional | None | $57.54 | $123.03 | $239.88 |
United Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $416.87 | Facility | None | $302.00 | $316.23 | $416.87 |
United Setting Professional Modifier None Typical Low $60.26 Median $128.82 Typical High $218.78 | Professional | None | $60.26 | $128.82 | $218.78 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $26.92 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $26.92 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $10.96 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $40.74 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $8.13 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.37 | $13.18 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $66.07 Typical High $89.13 | Professional | 52 · Reduced service | $26.92 | $66.07 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $10.96 | $26.92 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $100.00 Typical High $134.90 | Professional | 54 · Surgery only | $40.74 | $100.00 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $8.13 | $19.95 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.37 | $13.18 | $17.78 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 36th of 51
$145
AK $288MD $83.18
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.