How much rates vary
Facilitymedian $9,120 · 10th to 90th $5,129 to $13,490Professionalmedian $7,943 · 10th to 90th $5,888 to $95,499
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 $5,888.44 Median $5,888.44 Typical High $6,309.57 | Facility | None | $5,888.44 | $5,888.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $11,748.98 | Professional | None | $5,888.44 | $5,888.44 | $11,748.98 |
BCBS Texas Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
Christus Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $13,489.63 | Facility | None | $13,489.63 | $13,489.63 | $13,489.63 |
Cigna Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
Lucent Health Setting Professional Modifier None Typical Low $83,176.38 Median $95,499.26 Typical High $95,499.26 | Professional | None | $83,176.38 | $95,499.26 | $95,499.26 |
Moda Health Setting Facility Modifier None Typical Low $3,981.07 Median $7,585.78 Typical High $13,489.63 | Facility | None | $3,981.07 | $7,585.78 | $13,489.63 |
Moda Health Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $11,748.98 | Professional | None | $5,888.44 | $5,888.44 | $11,748.98 |
Molina Setting Professional Modifier None Typical Low $81.28 Median $10,000.00 Typical High $10,000.00 | Professional | None | $81.28 | $10,000.00 | $10,000.00 |
Providence Setting Facility Modifier None Typical Low $5,754.40 Median $9,120.11 Typical High $13,489.63 | Facility | None | $5,754.40 | $9,120.11 | $13,489.63 |
Providence Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $9,120.11 | Professional | None | $6,606.93 | $6,606.93 | $9,120.11 |
United Setting Facility Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $14,125.38 | Facility | None | $5,128.61 | $6,165.95 | $14,125.38 |
United Setting Professional Modifier None Typical Low $5,128.61 Median $7,585.78 Typical High $9,120.11 | Professional | None | $5,128.61 | $7,585.78 | $9,120.11 |
Wellpoint Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
8 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 $2,951.21 Median $2,951.21 Typical High $5,888.44 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $5,888.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $2,344.23 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $1,737.80 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $1,174.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2,951.21 Median $2,951.21 Typical High $5,888.44 | Professional | 52 · Reduced service | $2,951.21 | $2,951.21 | $5,888.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,174.90 Typical High $2,344.23 | Professional | 53 · Discontinued | $1,174.90 | $1,174.90 | $2,344.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $870.96 Median $870.96 Typical High $1,737.80 | Professional | 55 · Aftercare only | $870.96 | $870.96 | $1,737.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $588.84 Median $588.84 Typical High $1,174.90 | Professional | 56 · Pre-op care only | $588.84 | $588.84 | $1,174.90 |
Where Texas sits
The same service costs 2.5 times more in Montana than in Delaware. 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· 25th of 51
$8,128
MT $16,596DE $6,607
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.