How much rates vary
Facilitymedian $251 · 10th to 90th $115 to $3,311Professionalmedian $120 · 10th to 90th $27 to $234
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $123.03 Typical High $199.53 | Professional | None | $42.66 | $123.03 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | None | $131.83 | $144.54 | $144.54 |
BCBS Texas Setting Facility Modifier None Typical Low $112.20 Median $165.96 Typical High $1,071.52 | Facility | None | $112.20 | $165.96 | $1,071.52 |
BCBS Texas Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $218.78 | Professional | None | $45.71 | $117.49 | $218.78 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $1,479.11 | Facility | None | $117.49 | $165.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $117.49 Typical High $204.17 | Professional | None | $53.70 | $117.49 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,318.26 | $1,318.26 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $1,380.38 Typical High $4,786.30 | Facility | None | $69.18 | $1,380.38 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $123.03 Typical High $213.80 | Professional | None | $42.66 | $123.03 | $213.80 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $147.91 | Professional | None | $19.50 | $107.15 | $147.91 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $3,801.89 | Facility | None | $117.49 | $190.55 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $112.20 Typical High $204.17 | Professional | None | $53.70 | $112.20 | $204.17 |
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 $50.12 Median $109.65 Typical High $194.98 | Professional | None | $50.12 | $109.65 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $21.38 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $21.38 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $8.51 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $32.36 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $6.46 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.27 | $12.02 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $58.88 Typical High $75.86 | Professional | 52 · Reduced service | $21.38 | $58.88 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $8.51 | $23.44 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $89.13 Typical High $112.20 | Professional | 54 · Surgery only | $32.36 | $89.13 | $112.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $17.78 Typical High $22.39 | Professional | 55 · Aftercare only | $6.46 | $17.78 | $22.39 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $11.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $4.27 | $11.75 | $15.14 |
Where Texas sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 39th of 51
$132
AK $282MT $107
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.