How much rates vary
Facilitymedian $71 · 10th to 90th $59 to $72Professionalmedian $66 · 10th to 90th $58 to $95
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 $56.23 Median $58.88 Typical High $79.43 | Facility | None | $56.23 | $58.88 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $79.43 | Professional | None | $57.54 | $64.57 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | None | $70.79 | $70.79 | $72.44 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $79.43 | Professional | None | $58.88 | $66.07 | $79.43 |
Christus Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $128.82 | Professional | None | $58.88 | $81.28 | $128.82 |
Lucent Health Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $56.23 Median $63.10 Typical High $97.72 | Facility | None | $56.23 | $63.10 | $97.72 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $79.43 | Professional | None | $57.54 | $64.57 | $79.43 |
Molina Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $107.15 | Professional | None | $48.98 | $97.72 | $107.15 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $83.18 Typical High $123.03 | Facility | None | $72.44 | $83.18 | $123.03 |
Providence Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $128.82 | Professional | None | $61.66 | $79.43 | $128.82 |
United Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $91.20 | Professional | None | $56.23 | $72.44 | $91.20 |
Wellpoint Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
18 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 Facility Modifier 52 · Reduced service Typical Low $28.18 Median $28.84 Typical High $29.51 | Facility | 52 · Reduced service | $28.18 | $28.84 | $29.51 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.91 | Facility | 55 · Aftercare only | $8.32 | $8.71 | $8.91 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.89 | Facility | 56 · Pre-op care only | $5.62 | $5.75 | $5.89 |
Aetna Setting Facility Modifier AF · Specialist physician Typical Low $75.86 Median $79.43 Typical High $173.78 | Facility | AF · Specialist physician | $75.86 | $79.43 | $173.78 |
Aetna Setting Facility Modifier HO · Master's level Typical Low $57.54 Median $58.88 Typical High $131.83 | Facility | HO · Master's level | $57.54 | $58.88 | $131.83 |
Aetna Setting Facility Modifier TD · Registered nurse Typical Low $64.57 Median $67.61 Typical High $147.91 | Facility | TD · Registered nurse | $64.57 | $67.61 | $147.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.84 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.84 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.91 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $5.89 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $28.18 Median $28.84 Typical High $29.51 | Facility | 52 · Reduced service | $28.18 | $28.84 | $29.51 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.91 | Facility | 55 · Aftercare only | $8.32 | $8.71 | $8.91 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $5.89 | Facility | 56 · Pre-op care only | $5.62 | $5.75 | $5.89 |
Moda Health Setting Facility Modifier AF · Specialist physician Typical Low $75.86 Median $79.43 Typical High $173.78 | Facility | AF · Specialist physician | $75.86 | $79.43 | $173.78 |
Moda Health Setting Facility Modifier HO · Master's level Typical Low $57.54 Median $58.88 Typical High $131.83 | Facility | HO · Master's level | $57.54 | $58.88 | $131.83 |
Moda Health Setting Facility Modifier TD · Registered nurse Typical Low $64.57 Median $67.61 Typical High $147.91 | Facility | TD · Registered nurse | $64.57 | $67.61 | $147.91 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $28.18 | $28.84 | $30.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.62 | $5.75 | $6.17 |
Where Texas sits
The same service costs 2.6 times more in Alaska than in Utah. 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· 35th of 51
$70.79
AK $148UT $56.23
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.