How much rates vary
Facilitymedian $170 · 10th to 90th $65 to $2,188Professionalmedian $91 · 10th to 90th $40 to $724
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $144.54 | Professional | None | $40.74 | $79.43 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $251.19 | Professional | None | $97.72 | $97.72 | $251.19 |
BCBS Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $891.25 | Facility | None | $61.66 | $95.50 | $891.25 |
BCBS Setting Professional Modifier None Typical Low $51.29 Median $91.20 Typical High $190.55 | Professional | None | $51.29 | $91.20 | $190.55 |
Christus Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $128.82 | Facility | None | $58.88 | $79.43 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $173.78 | Professional | None | $58.88 | $104.71 | $173.78 |
Lucent Health Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | None | $724.44 | $724.44 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $1,202.26 Typical High $4,365.16 | Facility | None | $64.57 | $1,202.26 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $147.91 | Professional | None | $40.74 | $79.43 | $147.91 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $380.19 | Professional | None | $165.96 | $177.83 | $380.19 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $81.28 Typical High $141.25 | Facility | None | $53.70 | $81.28 | $141.25 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $173.78 | Professional | None | $58.88 | $104.71 | $173.78 |
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 $52.48 Median $91.20 Typical High $165.96 | Professional | None | $52.48 | $91.20 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $20.42 Median $38.02 Typical High $50.12 | Professional | 52 · Reduced service | $20.42 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $8.13 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $57.54 Typical High $74.13 | Professional | 54 · Surgery only | $30.90 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $6.17 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.59 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.07 | $7.59 | $10.00 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $38.02 Typical High $48.98 | Professional | 52 · Reduced service | $20.42 | $38.02 | $48.98 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $15.14 Typical High $19.50 | Professional | 53 · Discontinued | $8.13 | $15.14 | $19.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $57.54 Typical High $72.44 | Professional | 54 · Surgery only | $30.90 | $57.54 | $72.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.48 Typical High $14.79 | Professional | 55 · Aftercare only | $6.17 | $11.48 | $14.79 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.59 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.07 | $7.59 | $9.77 |
Where Texas sits
The same service costs 2.8 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· 47th of 51
$97.72
AK $257KY $93.33
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.