How much rates vary
Facilitymedian $316 · 10th to 90th $200 to $468Professionalmedian $251 · 10th to 90th $209 to $3,467
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 $208.93 Median $208.93 Typical High $213.80 | Facility | None | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $380.19 | Professional | None | $208.93 | $213.80 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $323.59 | Professional | None | $234.42 | $234.42 | $323.59 |
BCBS Texas Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $275.42 | Professional | None | $218.78 | $218.78 | $275.42 |
Christus Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,630.27 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $134.90 Median $263.03 Typical High $467.74 | Facility | None | $134.90 | $263.03 | $467.74 |
Moda Health Setting Professional Modifier None Typical Low $208.93 Median $213.80 Typical High $380.19 | Professional | None | $208.93 | $213.80 | $380.19 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $251.19 Typical High $251.19 | Professional | None | $81.28 | $251.19 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $199.53 Median $316.23 Typical High $467.74 | Facility | None | $199.53 | $316.23 | $467.74 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
United Setting Facility Modifier None Typical Low $245.47 Median $269.15 Typical High $478.63 | Facility | None | $245.47 | $269.15 | $478.63 |
United Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $302.00 | Professional | None | $162.18 | $229.09 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
9 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 Professional Modifier 52 · Reduced service Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $40.74 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $26.92 |
Ambetter Setting Professional Modifier KX · Policy requirements met Typical Low $234.42 Median $234.42 Typical High $467.74 | Professional | KX · Policy requirements met | $234.42 | $234.42 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $102.33 | $107.15 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $40.74 | $42.66 | $53.70 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $30.20 | $32.36 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $21.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.42 | $21.38 | $26.92 |
Where Texas sits
The same service costs 2.6 times more in Hawaii than in Arizona. 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· 39th of 51
$251
HI $589AZ $229
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.