How much rates vary
Facilitymedian $447 · 10th to 90th $112 to $2,291Professionalmedian $120 · 10th to 90th $25 to $251
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 $138.04 Median $3,715.35 Typical High $9,120.11 | Facility | None | $138.04 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $162.18 | Professional | None | $53.70 | $114.82 | $162.18 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
BCBS Texas Setting Facility Modifier None Typical Low $263.03 Median $537.03 Typical High $1,862.09 | Facility | None | $263.03 | $537.03 | $1,862.09 |
BCBS Texas Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $223.87 | Professional | None | $64.57 | $134.90 | $223.87 |
Christus Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $204.17 | Professional | None | $67.61 | $128.82 | $204.17 |
Lucent Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,096.48 | $1,096.48 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $60.26 Median $645.65 Typical High $5,248.07 | Facility | None | $60.26 | $645.65 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $173.78 | Professional | None | $53.70 | $114.82 | $173.78 |
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 $50.12 Median $81.28 Typical High $229.09 | Facility | None | $50.12 | $81.28 | $229.09 |
Providence Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $208.93 | Professional | None | $67.61 | $128.82 | $208.93 |
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 $60.26 Median $112.20 Typical High $181.97 | Professional | None | $60.26 | $112.20 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $26.92 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $26.92 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $23.44 Typical High $29.51 | Professional | 53 · Discontinued | $10.72 | $23.44 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $87.10 Typical High $109.65 | Professional | 54 · Surgery only | $39.81 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $17.38 Typical High $21.88 | Professional | 55 · Aftercare only | $7.94 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $11.75 Typical High $14.79 | Professional | 56 · Pre-op care only | $5.37 | $11.75 | $14.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $26.92 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $26.92 | $57.54 | $74.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $22.91 Typical High $29.51 | Professional | 53 · Discontinued | $10.72 | $22.91 | $29.51 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $87.10 Typical High $109.65 | Professional | 54 · Surgery only | $39.81 | $87.10 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $17.38 Typical High $21.88 | Professional | 55 · Aftercare only | $7.94 | $17.38 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $11.48 Typical High $14.79 | Professional | 56 · Pre-op care only | $5.37 | $11.48 | $14.79 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 34th of 51
$129
AK $355MD $100
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.