How much rates vary
Facilitymedian $631 · 10th to 90th $44 to $3,311Professionalmedian $60 · 10th to 90th $35 to $437
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 $426.58 Median $2,187.76 Typical High $6,760.83 | Facility | None | $426.58 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $75.86 | Professional | None | $38.02 | $48.98 | $75.86 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $50.12 Typical High $70.79 | Professional | None | $42.66 | $50.12 | $70.79 |
BCBS Texas Setting Facility Modifier None Typical Low $891.25 Median $1,905.46 Typical High $4,073.80 | Facility | None | $891.25 | $1,905.46 | $4,073.80 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $95.50 | Professional | None | $44.67 | $60.26 | $95.50 |
Christus Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $95.50 | Professional | None | $52.48 | $66.07 | $95.50 |
Lucent Health Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | None | $436.52 | $512.86 | $512.86 |
Moda Health Setting Facility Modifier None Typical Low $53.70 Median $588.84 Typical High $3,715.35 | Facility | None | $53.70 | $588.84 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $81.28 | Professional | None | $38.02 | $50.12 | $81.28 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $72.44 | Professional | None | $9.77 | $53.70 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $223.87 | Professional | None | $154.88 | $165.96 | $223.87 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $588.84 Typical High $2,691.53 | Facility | None | $44.67 | $588.84 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $95.50 | Professional | None | $52.48 | $66.07 | $95.50 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $41.69 Median $58.88 Typical High $89.13 | Professional | None | $41.69 | $58.88 | $89.13 |
Wellpoint Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $19.05 Median $22.91 Typical High $28.84 | Professional | 52 · Reduced service | $19.05 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.12 Typical High $11.48 | Professional | 53 · Discontinued | $7.59 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $34.67 Typical High $42.66 | Professional | 54 · Surgery only | $28.84 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $8.51 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.57 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.80 | $4.57 | $5.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $22.91 Typical High $28.84 | Professional | 52 · Reduced service | $19.05 | $22.91 | $28.84 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.12 Typical High $11.48 | Professional | 53 · Discontinued | $7.59 | $9.12 | $11.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $34.67 Typical High $42.66 | Professional | 54 · Surgery only | $28.84 | $34.67 | $42.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $8.51 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $8.51 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.57 Typical High $5.75 | Professional | 56 · Pre-op care only | $3.80 | $4.57 | $5.75 |
Where Texas sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 44th of 51
$61.66
AK $240KY $50.12
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.