How much rates vary
Facilitymedian $234 · 10th to 90th $102 to $437Professionalmedian $107 · 10th to 90th $105 to $110
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 $109.65 Median $158.49 Typical High $229.09 | Facility | None | $109.65 | $158.49 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | None | $109.65 | $109.65 | $120.23 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $239.88 Typical High $457.09 | Facility | None | $95.50 | $239.88 | $457.09 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $208.93 Typical High $346.74 | Facility | None | $109.65 | $208.93 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Moda Health Setting Facility Modifier None Typical Low $104.71 Median $125.89 Typical High $218.78 | Facility | None | $104.71 | $125.89 | $218.78 |
Moda Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | None | $104.71 | $104.71 | $114.82 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Providence Setting Facility Modifier None Typical Low $104.71 Median $154.88 Typical High $933.25 | Facility | None | $104.71 | $154.88 | $933.25 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
15 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 $54.95 Median $83.18 Typical High $114.82 | Facility | 52 · Reduced service | $54.95 | $83.18 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $21.88 Median $33.11 Typical High $45.71 | Facility | 53 · Discontinued | $21.88 | $33.11 | $45.71 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $83.18 Median $125.89 Typical High $169.82 | Facility | 54 · Surgery only | $83.18 | $125.89 | $169.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $34.67 | Facility | 55 · Aftercare only | $16.60 | $25.12 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.60 Typical High $22.91 | Facility | 56 · Pre-op care only | $10.96 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | 52 · Reduced service | $54.95 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $23.99 | Professional | 53 · Discontinued | $21.88 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 54 · Surgery only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 52 · Reduced service | $52.48 | $52.48 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $21.88 | Professional | 53 · Discontinued | $20.89 | $21.38 | $21.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 54 · Surgery only | $79.43 | $79.43 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $16.22 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.96 |
Where Texas sits
The same service costs 5.0 times more in Alabama 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· 4th of 51
$151
AL $525MD $105
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.