How much rates vary
Facilitymedian $776 · 10th to 90th $603 to $2,138Professionalmedian $537 · 10th to 90th $525 to $562
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 $537.03 Median $794.33 Typical High $1,148.15 | Facility | None | $537.03 | $794.33 | $1,148.15 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | None | $537.03 | $537.03 | $588.84 |
BCBS Texas Setting Facility Modifier None Typical Low $588.84 Median $1,412.54 Typical High $2,511.89 | Facility | None | $588.84 | $1,412.54 | $2,511.89 |
BCBS Texas Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Christus Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Facility | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,698.24 | Facility | None | $537.03 | $1,000.00 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $1,288.25 | Facility | None | $524.81 | $691.83 | $1,288.25 |
Moda Health Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $691.83 | Professional | None | $524.81 | $537.03 | $691.83 |
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 $537.03 Median $758.58 Typical High $4,570.88 | Facility | None | $537.03 | $758.58 | $4,570.88 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
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 $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $269.15 Median $416.87 Typical High $575.44 | Facility | 52 · Reduced service | $269.15 | $416.87 | $575.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $107.15 Median $169.82 Typical High $229.09 | Facility | 53 · Discontinued | $107.15 | $169.82 | $229.09 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $79.43 Median $125.89 Typical High $173.78 | Facility | 55 · Aftercare only | $79.43 | $125.89 | $173.78 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $53.70 Median $83.18 Typical High $114.82 | Facility | 56 · Pre-op care only | $53.70 | $83.18 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $79.43 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $58.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $275.42 | Professional | 52 · Reduced service | $263.03 | $263.03 | $275.42 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $109.65 | Professional | 53 · Discontinued | $104.71 | $107.15 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $54.95 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $54.95 |
Where Texas sits
The same service costs 5.0 times more in Wyoming than in Alabama. 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
$741
WY $1,175AL $234
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.