How much rates vary
Facilitymedian $229 · 10th to 90th $79 to $437Professionalmedian $63 · 10th to 90th $60 to $63
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 $95.50 Typical High $128.82 | Facility | None | $61.66 | $95.50 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $70.79 | Professional | None | $60.26 | $61.66 | $70.79 |
BCBS Texas Setting Facility Modifier None Typical Low $114.82 Median $251.19 Typical High $457.09 | Facility | None | $114.82 | $251.19 | $457.09 |
BCBS Texas Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $204.17 | Facility | None | $63.10 | $95.50 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $75.86 Typical High $123.03 | Facility | None | $60.26 | $75.86 | $123.03 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $61.66 |
Molina Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $75.86 Typical High $549.54 | Facility | None | $61.66 | $75.86 | $549.54 |
Providence Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $30.90 Median $47.86 Typical High $64.57 | Facility | 52 · Reduced service | $30.90 | $47.86 | $64.57 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.30 Median $19.05 Typical High $25.70 | Facility | 53 · Discontinued | $12.30 | $19.05 | $25.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $14.13 Typical High $19.50 | Facility | 55 · Aftercare only | $9.33 | $14.13 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.17 Median $9.55 Typical High $12.88 | Facility | 56 · Pre-op care only | $6.17 | $9.55 | $12.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $35.48 | Professional | 52 · Reduced service | $30.20 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $14.13 | Professional | 53 · Discontinued | $12.02 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $10.72 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $7.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.20 | $30.90 | $30.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.02 | $12.30 | $12.30 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.03 | $6.17 | $6.17 |
Where Texas sits
The same service costs 3.2 times more in Kansas than in Arkansas. 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
$138
KS $182AR $57.54
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.