How much rates vary
Facilitymedian $126 · 10th to 90th $36 to $245Professionalmedian $32 · 10th to 90th $32 to $33
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 $31.62 Median $50.12 Typical High $69.18 | Facility | None | $31.62 | $50.12 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $34.67 | Professional | None | $31.62 | $32.36 | $34.67 |
BCBS Texas Setting Facility Modifier None Typical Low $57.54 Median $147.91 Typical High $245.47 | Facility | None | $57.54 | $147.91 | $245.47 |
BCBS Texas Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Baylor Scott & White Setting Facility Modifier None Typical Low $23.44 Median $31.62 Typical High $194.98 | Facility | None | $23.44 | $31.62 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $60.26 Typical High $102.33 | Facility | None | $31.62 | $60.26 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Moda Health Setting Facility Modifier None Typical Low $31.62 Median $81.28 Typical High $147.91 | Facility | None | $31.62 | $81.28 | $147.91 |
Moda Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | None | $31.62 | $31.62 | $33.11 |
Molina Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Providence Setting Facility Modifier None Typical Low $22.39 Median $38.02 Typical High $269.15 | Facility | None | $22.39 | $38.02 | $269.15 |
Providence Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
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 $15.85 Median $25.12 Typical High $34.67 | Facility | 52 · Reduced service | $15.85 | $25.12 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.31 Median $10.00 Typical High $13.80 | Facility | 53 · Discontinued | $6.31 | $10.00 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.79 Median $7.59 Typical High $10.23 | Facility | 55 · Aftercare only | $4.79 | $7.59 | $10.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.01 Typical High $6.92 | Facility | 56 · Pre-op care only | $3.16 | $5.01 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.22 Typical High $17.38 | Professional | 52 · Reduced service | $15.85 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.46 Typical High $6.92 | Professional | 53 · Discontinued | $6.31 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.24 Typical High $3.47 | Professional | 56 · Pre-op care only | $3.16 | $3.24 | $3.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $15.85 Typical High $16.60 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.60 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.61 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.61 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.79 Typical High $4.90 | Professional | 55 · Aftercare only | $4.68 | $4.79 | $4.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.31 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.31 |
Where Texas sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 2nd of 51
$74.13
AL $120VA $31.62
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.