How much rates vary
Facilitymedian $138 · 10th to 90th $83 to $2,188Professionalmedian $112 · 10th to 90th $25 to $224
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 $125.89 Median $3,715.35 Typical High $9,120.11 | Facility | None | $125.89 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $147.91 | Professional | None | $47.86 | $102.33 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | None | $114.82 | $125.89 | $125.89 |
BCBS Setting Facility Modifier None Typical Low $83.18 Median $123.03 Typical High $812.83 | Facility | None | $83.18 | $123.03 | $812.83 |
BCBS Setting Professional Modifier None Typical Low $56.23 Median $120.23 Typical High $208.93 | Professional | None | $56.23 | $120.23 | $208.93 |
Baylor Scott & White Setting Facility Modifier None Typical Low $61.66 Median $199.53 Typical High $251.19 | Facility | None | $61.66 | $199.53 | $251.19 |
Christus Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $158.49 | Facility | None | $66.07 | $112.20 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $190.55 | Professional | None | $58.88 | $114.82 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | None | $977.24 | $977.24 | $1,148.15 |
Moda Health Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $5,248.07 | Facility | None | $54.95 | $239.88 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $104.71 Typical High $165.96 | Professional | None | $47.86 | $104.71 | $165.96 |
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 $58.88 Median $112.20 Typical High $165.96 | Facility | None | $58.88 | $112.20 | $165.96 |
Providence Setting Professional Modifier None Typical Low $58.88 Median $117.49 Typical High $190.55 | Professional | None | $58.88 | $117.49 | $190.55 |
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 $53.70 Median $100.00 Typical High $165.96 | Professional | None | $53.70 | $100.00 | $165.96 |
Wellpoint Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $23.99 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $23.99 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $21.38 Typical High $26.92 | Professional | 53 · Discontinued | $9.55 | $21.38 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $79.43 Typical High $102.33 | Professional | 54 · Surgery only | $35.48 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $7.08 | $15.85 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $10.72 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.79 | $10.72 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $23.99 | $52.48 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $21.38 Typical High $26.92 | Professional | 53 · Discontinued | $9.55 | $21.38 | $26.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $79.43 Typical High $102.33 | Professional | 54 · Surgery only | $35.48 | $79.43 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $15.85 Typical High $20.42 | Professional | 55 · Aftercare only | $7.08 | $15.85 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $10.72 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.79 | $10.72 | $13.49 |
Where Texas sits
The same service costs 3.1 times more in Wisconsin 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· 25th of 51
$120
WI $269KY $87.10
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.