How much rates vary
Facilitymedian $813 · 10th to 90th $186 to $1,549Professionalmedian $132 · 10th to 90th $28 to $135
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 $131.83 Median $190.55 Typical High $263.03 | Facility | None | $131.83 | $190.55 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $144.54 | Professional | None | $131.83 | $134.90 | $144.54 |
BCBS Texas Setting Facility Modifier None Typical Low $389.05 Median $954.99 Typical High $1,621.81 | Facility | None | $389.05 | $954.99 | $1,621.81 |
BCBS Texas Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $251.19 Typical High $416.87 | Facility | None | $131.83 | $251.19 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $177.83 Typical High $331.13 | Facility | None | $120.23 | $177.83 | $331.13 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | None | $120.23 | $120.23 | $131.83 |
Molina Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $190.55 Typical High $1,122.02 | Facility | None | $131.83 | $190.55 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $131.83 | Professional | None | $120.23 | $128.82 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $66.07 Median $95.50 Typical High $131.83 | Facility | 52 · Reduced service | $66.07 | $95.50 | $131.83 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $38.02 Typical High $52.48 | Facility | 53 · Discontinued | $26.30 | $38.02 | $52.48 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $38.90 | Facility | 55 · Aftercare only | $19.95 | $28.84 | $38.90 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.05 Typical High $26.30 | Facility | 56 · Pre-op care only | $13.18 | $19.05 | $26.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 52 · Reduced service | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $26.30 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | 52 · Reduced service | $60.26 | $60.26 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $24.55 | Professional | 53 · Discontinued | $23.99 | $23.99 | $24.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $18.20 Typical High $18.62 | Professional | 55 · Aftercare only | $17.78 | $18.20 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $12.30 |
Where Texas sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 1st of 51
$355
TX $355KS $40.74
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.