How much rates vary
Facilitymedian $219 · 10th to 90th $174 to $759Professionalmedian $69 · 10th to 90th $35 to $759
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 $69.18 Median $85.11 Typical High $117.49 | Facility | None | $69.18 | $85.11 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $93.33 | Professional | None | $63.10 | $81.28 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
BCBS Texas Setting Facility Modifier None Typical Low $173.78 Median $467.74 Typical High $912.01 | Facility | None | $173.78 | $467.74 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Christus Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $177.83 Typical High $691.83 | Facility | None | $60.26 | $177.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $56.23 Typical High $64.57 | Professional | None | $26.92 | $56.23 | $64.57 |
Lucent Health Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $758.58 | Professional | None | $575.44 | $758.58 | $758.58 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $194.98 Typical High $512.86 | Facility | None | $46.77 | $194.98 | $512.86 |
Moda Health Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $102.33 | Professional | None | $63.10 | $81.28 | $102.33 |
Molina Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $57.54 | Professional | None | $25.70 | $33.11 | $57.54 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $91.20 Typical High $691.83 | Facility | None | $42.66 | $91.20 | $691.83 |
Providence Setting Professional Modifier None Typical Low $26.92 Median $56.23 Typical High $64.57 | Professional | None | $26.92 | $56.23 | $64.57 |
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 $30.90 Median $69.18 Typical High $85.11 | Professional | None | $30.90 | $69.18 | $85.11 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $34.67 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $34.67 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $13.80 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $69.18 | Professional | 54 · Surgery only | $51.29 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $10.23 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.92 | $8.13 | $9.33 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $40.74 Typical High $46.77 | Professional | 52 · Reduced service | $34.67 | $40.74 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $13.80 | $16.60 | $18.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $61.66 Typical High $69.18 | Professional | 54 · Surgery only | $51.29 | $61.66 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $10.23 | $12.30 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.13 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.92 | $8.13 | $9.33 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Ohio. 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· 12th of 51
$91.20
AK $141OH $31.62
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.