How much rates vary
Facilitymedian $174 · 10th to 90th $105 to $427Professionalmedian $126 · 10th to 90th $71 to $1,096
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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $72.44 | Professional | None | $70.79 | $70.79 | $72.44 |
BCBS Texas Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $436.52 | Facility | None | $107.15 | $190.55 | $436.52 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $100.00 | Facility | None | $70.79 | $70.79 | $100.00 |
Moda Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | None | $70.79 | $70.79 | $77.62 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $131.83 | Professional | None | $69.18 | $69.18 | $131.83 |
Providence Setting Facility Modifier None Typical Low $70.79 Median $144.54 Typical High $1,096.48 | Facility | None | $70.79 | $144.54 | $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 $35.48 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $35.48 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.24 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $35.48 | $36.31 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.45 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.96 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.96 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.24 |
Where Texas sits
The same service costs 3.6 times more in Wyoming than in Indiana. 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· 21st of 51
$126
WY $257IN $70.79
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.