How much rates vary
Facilitymedian $151 · 10th to 90th $8 to $490Professionalmedian $126 · 10th to 90th $126 to $2,089
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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
BCBS Texas Setting Facility Modifier None Typical Low $7.08 Median $8.91 Typical High $23.44 | Facility | None | $7.08 | $8.91 | $23.44 |
BCBS Texas Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Christus Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $407.38 | Facility | None | $125.89 | $245.47 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,949.84 | $2,089.30 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $691.83 | Facility | None | $489.78 | $489.78 | $691.83 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $407.38 Typical High $1,096.48 | Facility | None | $144.54 | $407.38 | $1,096.48 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $245.47 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $245.47 | $245.47 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $97.72 | $97.72 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $50.12 |
Where Texas sits
The same service costs 7.1 times more in Wyoming than in North Carolina. 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· 38th of 51
$126
WY $832NC $117
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.