How much rates vary
Facilitymedian $759 · 10th to 90th $372 to $3,802Professionalmedian $501 · 10th to 90th $191 to $2,818
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 $645.65 Median $2,398.83 Typical High $6,918.31 | Facility | None | $645.65 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $2,089.30 | Professional | None | $288.40 | $302.00 | $2,089.30 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
BCBS Texas Setting Facility Modifier None Typical Low $316.23 Median $602.56 Typical High $1,737.80 | Facility | None | $316.23 | $602.56 | $1,737.80 |
BCBS Texas Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | None | $51.29 | $51.29 | $60.26 |
Christus Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,479.11 | Facility | None | $398.11 | $562.34 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $138.04 Median $1,819.70 Typical High $5,495.41 | Facility | None | $138.04 | $1,819.70 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $316.23 | Professional | None | $288.40 | $302.00 | $316.23 |
Providence Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $3,890.45 | Facility | None | $371.54 | $616.60 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $154.88 Median $295.12 Typical High $436.52 | Professional | None | $154.88 | $295.12 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $501.19 Typical High $501.19 | Professional | None | $186.21 | $501.19 | $501.19 |
10 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 $144.54 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $144.54 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $234.42 | Professional | 54 · Surgery only | $218.78 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $46.77 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $151.36 Typical High $158.49 | Professional | 52 · Reduced service | $144.54 | $151.36 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $63.10 | Professional | 53 · Discontinued | $57.54 | $60.26 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $223.87 Typical High $234.42 | Professional | 54 · Surgery only | $218.78 | $223.87 | $234.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $44.67 Typical High $46.77 | Professional | 55 · Aftercare only | $43.65 | $44.67 | $46.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $31.62 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $31.62 |
Where Texas sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 4th of 51
$676
OK $1,514RI $182
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.