How much rates vary
Facilitymedian $186 · 10th to 90th $117 to $427Professionalmedian $148 · 10th to 90th $117 to $178
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 $117.49 Median $190.55 Typical High $316.23 | Facility | None | $117.49 | $190.55 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | None | $117.49 | $117.49 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $102.33 Median $223.87 Typical High $436.52 | Facility | None | $102.33 | $223.87 | $436.52 |
BCBS Texas Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
Baylor Scott & White Setting Facility Modifier None Typical Low $147.91 Median $162.18 Typical High $457.09 | Facility | None | $147.91 | $162.18 | $457.09 |
Christus Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $229.09 Typical High $371.54 | Facility | None | $117.49 | $229.09 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $346.74 Typical High $776.25 | Facility | None | $147.91 | $346.74 | $776.25 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | None | $147.91 | $147.91 | $162.18 |
Molina Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $165.96 | Professional | None | $117.49 | $147.91 | $165.96 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $1,000.00 | Facility | None | $117.49 | $165.96 | $1,000.00 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $58.88 Median $117.49 Typical High $158.49 | Facility | 52 · Reduced service | $58.88 | $117.49 | $158.49 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.44 Median $46.77 Typical High $64.57 | Facility | 53 · Discontinued | $23.44 | $46.77 | $64.57 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $17.78 Median $34.67 Typical High $47.86 | Facility | 55 · Aftercare only | $17.78 | $34.67 | $47.86 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $11.75 Median $23.44 Typical High $31.62 | Facility | 56 · Pre-op care only | $11.75 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $58.88 Typical High $64.57 | Professional | 52 · Reduced service | $58.88 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $19.50 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.88 |
Moda Health Setting Facility Modifier JZ · No drug discarded Typical Low $263.03 Median $537.03 Typical High $691.83 | Facility | JZ · No drug discarded | $263.03 | $537.03 | $691.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $74.13 Typical High $75.86 | Professional | 52 · Reduced service | $72.44 | $74.13 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $30.20 | Professional | 53 · Discontinued | $29.51 | $29.51 | $30.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $22.39 Typical High $22.91 | Professional | 55 · Aftercare only | $21.88 | $22.39 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $15.14 |
Where Texas sits
The same service costs 2.0 times more in Kansas than in Georgia. 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· 9th of 51
$186
KS $234GA $117
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.