How much rates vary
Facilitymedian $331 · 10th to 90th $87 to $603Professionalmedian $78 · 10th to 90th $47 to $83
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 $61.66 Median $79.43 Typical High $102.33 | Facility | None | $61.66 | $79.43 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | None | $77.62 | $79.43 | $79.43 |
BCBS Texas Setting Facility Modifier None Typical Low $181.97 Median $389.05 Typical High $630.96 | Facility | None | $181.97 | $389.05 | $630.96 |
BCBS Texas Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $147.91 Typical High $245.47 | Facility | None | $77.62 | $147.91 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $93.33 Typical High $162.18 | Facility | None | $46.77 | $93.33 | $162.18 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $51.29 | Professional | None | $46.77 | $47.86 | $51.29 |
Molina Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $660.69 | Facility | None | $72.44 | $112.20 | $660.69 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Wellpoint Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
13 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 $30.90 Median $38.90 Typical High $51.29 | Facility | 52 · Reduced service | $30.90 | $38.90 | $51.29 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $15.85 Typical High $20.42 | Facility | 53 · Discontinued | $12.30 | $15.85 | $20.42 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $11.75 Typical High $15.49 | Facility | 55 · Aftercare only | $9.33 | $11.75 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.94 Typical High $10.23 | Facility | 56 · Pre-op care only | $6.17 | $7.94 | $10.23 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 52 · Reduced service | $38.90 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.49 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $12.02 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.76 | $7.94 | $7.94 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $60.26 Median $91.20 Typical High $120.23 | Facility | JZ · No drug discarded | $60.26 | $91.20 | $120.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $23.44 Typical High $24.55 | Professional | 52 · Reduced service | $23.44 | $23.44 | $24.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.55 Typical High $9.77 | Professional | 53 · Discontinued | $9.33 | $9.55 | $9.77 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.24 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.79 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.68 | $4.79 | $4.90 |
Where Texas sits
The same service costs 3.6 times more in Texas than in Kansas. 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
$151
TX $151KS $41.69
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.