How much rates vary
Facilitymedian $1,288 · 10th to 90th $525 to $2,291Professionalmedian $513 · 10th to 90th $490 to $525
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 $501.19 Median $776.25 Typical High $1,047.13 | Facility | None | $501.19 | $776.25 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $575.44 | Professional | None | $489.78 | $501.19 | $575.44 |
BCBS Texas Setting Facility Modifier None Typical Low $549.54 Median $1,380.38 Typical High $2,398.83 | Facility | None | $549.54 | $1,380.38 | $2,398.83 |
BCBS Texas Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $776.25 Typical High $1,659.59 | Facility | None | $524.81 | $776.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Moda Health Setting Facility Modifier None Typical Low $501.19 Median $630.96 Typical High $1,174.90 | Facility | None | $501.19 | $630.96 | $1,174.90 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $501.19 Typical High $524.81 | Professional | None | $489.78 | $501.19 | $524.81 |
Molina Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $4,466.84 | Facility | None | $524.81 | $630.96 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $251.19 Median $389.05 Typical High $524.81 | Facility | 52 · Reduced service | $251.19 | $389.05 | $524.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $100.00 Median $154.88 Typical High $213.80 | Facility | 53 · Discontinued | $100.00 | $154.88 | $213.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $158.49 | Facility | 55 · Aftercare only | $75.86 | $117.49 | $158.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $50.12 Median $77.62 Typical High $104.71 | Facility | 56 · Pre-op care only | $50.12 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $245.47 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $97.72 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $251.19 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $100.00 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $74.13 | $75.86 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $50.12 | $50.12 |
Where Texas sits
The same service costs 1.7 times more in Arizona 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· 3rd of 51
$776
AZ $851HI $490
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.