How much rates vary
Facilitymedian $224 · 10th to 90th $30 to $3,890Professionalmedian $47 · 10th to 90th $12 to $324
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 $34.67 Median $3,715.35 Typical High $9,120.11 | Facility | None | $34.67 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $34.67 Typical High $54.95 | Professional | None | $23.44 | $34.67 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $63.10 | Professional | None | $41.69 | $48.98 | $63.10 |
BCBS Texas Setting Facility Modifier None Typical Low $4,073.80 Median $8,709.64 Typical High $8,709.64 | Facility | None | $4,073.80 | $8,709.64 | $8,709.64 |
BCBS Texas Setting Professional Modifier None Typical Low $27.54 Median $43.65 Typical High $54.95 | Professional | None | $27.54 | $43.65 | $54.95 |
Baylor Scott & White Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $75.86 | Facility | None | $32.36 | $32.36 | $75.86 |
Baylor Scott & White Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | None | $54.95 | $54.95 | $61.66 |
Christus Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $2,691.53 | Facility | None | $524.81 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Lucent Health Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $436.52 | Professional | None | $323.59 | $436.52 | $436.52 |
Moda Health Setting Facility Modifier None Typical Low $26.92 Median $131.83 Typical High $5,248.07 | Facility | None | $26.92 | $131.83 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $60.26 | Professional | None | $23.44 | $37.15 | $60.26 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $72.44 | Professional | None | $9.77 | $53.70 | $72.44 |
Providence Setting Facility Modifier None Typical Low $26.92 Median $63.10 Typical High $2,691.53 | Facility | None | $26.92 | $63.10 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $27.54 Median $42.66 Typical High $69.18 | Professional | None | $27.54 | $42.66 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
11 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 $9.55 Median $15.14 Typical High $22.39 | Professional | 52 · Reduced service | $9.55 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $6.03 Typical High $9.12 | Professional | 53 · Discontinued | $3.80 | $6.03 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $22.39 Typical High $33.88 | Professional | 54 · Surgery only | $14.13 | $22.39 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $4.47 Typical High $6.76 | Professional | 55 · Aftercare only | $2.82 | $4.47 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.02 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.91 | $3.02 | $4.47 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | 59 · Distinct service | $53.70 | $53.70 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $15.14 Typical High $21.88 | Professional | 52 · Reduced service | $9.55 | $15.14 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $6.03 Typical High $8.91 | Professional | 53 · Discontinued | $3.80 | $6.03 | $8.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $22.39 Typical High $33.11 | Professional | 54 · Surgery only | $14.13 | $22.39 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $4.47 Typical High $6.61 | Professional | 55 · Aftercare only | $2.82 | $4.47 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $3.02 Typical High $4.37 | Professional | 56 · Pre-op care only | $1.91 | $3.02 | $4.37 |
Where Texas sits
The same service costs 2.8 times more in Alaska than in California. 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· 45th of 51
$46.77
AK $129CA $46.77
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.