How much rates vary
Facilitymedian $1,096 · 10th to 90th $550 to $3,236Professionalmedian $661 · 10th to 90th $562 to $692
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 $562.34 Median $1,000.00 Typical High $1,445.44 | Facility | None | $562.34 | $1,000.00 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $1,000.00 | Professional | None | $562.34 | $575.44 | $1,000.00 |
BCBS Texas Setting Facility Modifier None Typical Low $891.25 Median $2,137.96 Typical High $3,801.89 | Facility | None | $891.25 | $2,137.96 | $3,801.89 |
BCBS Texas Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Christus Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,819.70 | Facility | None | $562.34 | $1,071.52 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $912.01 Typical High $2,290.87 | Facility | None | $660.69 | $912.01 | $2,290.87 |
Moda Health Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $1,000.00 | Professional | None | $575.44 | $660.69 | $1,000.00 |
Molina Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $457.09 | Professional | None | $398.11 | $398.11 | $457.09 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $812.83 Typical High $4,786.30 | Facility | None | $562.34 | $812.83 | $4,786.30 |
Providence Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $281.84 Median $524.81 Typical High $707.95 | Facility | 52 · Reduced service | $281.84 | $524.81 | $707.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $112.20 Median $208.93 Typical High $288.40 | Facility | 53 · Discontinued | $112.20 | $208.93 | $288.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $85.11 Median $158.49 Typical High $213.80 | Facility | 55 · Aftercare only | $85.11 | $158.49 | $213.80 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $56.23 Median $104.71 Typical High $144.54 | Facility | 56 · Pre-op care only | $56.23 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $281.84 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $123.03 | Professional | 53 · Discontinued | $112.20 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $57.54 Typical High $61.66 | Professional | 56 · Pre-op care only | $56.23 | $57.54 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $331.13 | $331.13 | $338.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $131.83 | $131.83 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $102.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $67.61 |
Where Texas sits
The same service costs 2.7 times more in Wyoming 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· 16th of 51
$676
WY $1,514GA $562
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.