How much rates vary
Facilitymedian $151 · 10th to 90th $25 to $1,995Professionalmedian $76 · 10th to 90th $18 to $158
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 $93.33 Median $2,089.30 Typical High $6,760.83 | Facility | None | $93.33 | $2,089.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $74.13 Typical High $125.89 | Professional | None | $26.92 | $74.13 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $24.55 Median $67.61 Typical High $97.72 | Professional | None | $24.55 | $67.61 | $97.72 |
BCBS Texas Setting Facility Modifier None Typical Low $12.30 Median $52.48 Typical High $131.83 | Facility | None | $12.30 | $52.48 | $131.83 |
BCBS Texas Setting Professional Modifier None Typical Low $28.84 Median $72.44 Typical High $128.82 | Professional | None | $28.84 | $72.44 | $128.82 |
Baylor Scott & White Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $83.18 | Professional | None | $33.11 | $38.90 | $83.18 |
Christus Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $75.86 Typical High $691.83 | Facility | None | $26.92 | $75.86 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $46.77 Typical High $75.86 | Professional | None | $16.98 | $46.77 | $75.86 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $870.96 | Professional | None | $645.65 | $645.65 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $295.12 Typical High $3,715.35 | Facility | None | $67.61 | $295.12 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $26.92 Median $69.18 Typical High $138.04 | Professional | None | $26.92 | $69.18 | $138.04 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Oscar Health Setting Facility Modifier None Typical Low $223.87 Median $575.44 Typical High $575.44 | Facility | None | $223.87 | $575.44 | $575.44 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $75.86 Typical High $173.78 | Facility | None | $30.90 | $75.86 | $173.78 |
Providence Setting Professional Modifier None Typical Low $16.98 Median $46.77 Typical High $75.86 | Professional | None | $16.98 | $46.77 | $75.86 |
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 $20.89 Median $54.95 Typical High $89.13 | Professional | None | $20.89 | $54.95 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
9 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 54 · Surgery only Typical Low $20.42 Median $53.70 Typical High $79.43 | Professional | 54 · Surgery only | $20.42 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $4.07 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $7.24 Typical High $10.47 | Professional | 56 · Pre-op care only | $2.69 | $7.24 | $10.47 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $24.55 Median $57.54 Typical High $77.62 | Professional | 59 · Distinct service | $24.55 | $57.54 | $77.62 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $37.15 Median $67.61 Typical High $102.33 | Professional | Q6 · Substitute physician, paid per time | $37.15 | $67.61 | $102.33 |
Moda Health Setting Facility Modifier GP · Physical therapy plan Typical Low $165.96 Median $263.03 Typical High $524.81 | Facility | GP · Physical therapy plan | $165.96 | $263.03 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $20.42 Median $53.70 Typical High $79.43 | Professional | 54 · Surgery only | $20.42 | $53.70 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $4.07 | $10.96 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $9.33 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.63 | $9.33 | $10.72 |
Where Texas sits
The same service costs 2.8 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· 25th of 51
$77.62
AK $141KY $51.29
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.