How much rates vary
Facilitymedian $380 · 10th to 90th $120 to $468Professionalmedian $117 · 10th to 90th $112 to $120
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 $114.82 Median $177.83 Typical High $245.47 | Facility | None | $114.82 | $177.83 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $134.90 | Professional | None | $112.20 | $114.82 | $134.90 |
BCBS Texas Setting Facility Modifier None Typical Low $120.23 Median $295.12 Typical High $524.81 | Facility | None | $120.23 | $295.12 | $524.81 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Christus Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $281.84 Typical High $380.19 | Facility | None | $120.23 | $281.84 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $141.25 Typical High $234.42 | Facility | None | $114.82 | $141.25 | $234.42 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | None | $112.20 | $114.82 | $114.82 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $162.18 Typical High $1,023.29 | Facility | None | $117.49 | $162.18 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
12 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 $57.54 Median $89.13 Typical High $123.03 | Facility | 52 · Reduced service | $57.54 | $89.13 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $35.48 Typical High $48.98 | Facility | 53 · Discontinued | $23.44 | $35.48 | $48.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.38 Median $26.92 Typical High $36.31 | Facility | 55 · Aftercare only | $17.38 | $26.92 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.48 Median $17.78 Typical High $24.55 | Facility | 56 · Pre-op care only | $11.48 | $17.78 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $56.23 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $26.92 | Professional | 53 · Discontinued | $22.91 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $56.23 | $57.54 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $22.91 | $23.44 | $23.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.98 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.22 | $11.48 | $11.48 |
Where Texas sits
The same service costs 2.3 times more in Texas than in Hawaii. 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· 1st of 51
$263
TX $263HI $115
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.