How much rates vary
Facilitymedian $123 · 10th to 90th $83 to $2,188Professionalmedian $87 · 10th to 90th $21 to $174
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 $104.71 Median $3,715.35 Typical High $9,120.11 | Facility | None | $104.71 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $79.43 Typical High $125.89 | Professional | None | $33.88 | $79.43 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $107.15 Typical High $107.15 | Professional | None | $35.48 | $107.15 | $107.15 |
BCBS Texas Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $794.33 | Facility | None | $77.62 | $123.03 | $794.33 |
BCBS Texas Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $165.96 | Professional | None | $36.31 | $85.11 | $165.96 |
Christus Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $151.36 | Facility | None | $66.07 | $102.33 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $151.36 | Professional | None | $42.66 | $85.11 | $151.36 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Professional | None | $812.83 | $812.83 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $39.81 Median $234.42 Typical High $4,786.30 | Facility | None | $39.81 | $234.42 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $79.43 Typical High $141.25 | Professional | None | $33.88 | $79.43 | $141.25 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $81.28 Typical High $109.65 | Professional | None | $14.79 | $81.28 | $109.65 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $104.71 Typical High $151.36 | Facility | None | $50.12 | $104.71 | $151.36 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $87.10 Typical High $151.36 | Professional | None | $42.66 | $87.10 | $151.36 |
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 $38.90 Median $74.13 Typical High $131.83 | Professional | None | $38.90 | $74.13 | $131.83 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $16.98 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $16.98 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $17.38 Typical High $22.39 | Professional | 53 · Discontinued | $6.92 | $17.38 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $66.07 Typical High $83.18 | Professional | 54 · Surgery only | $25.70 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $5.13 | $13.18 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $8.71 Typical High $11.22 | Professional | 56 · Pre-op care only | $3.39 | $8.71 | $11.22 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $16.98 | $43.65 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $17.38 Typical High $22.39 | Professional | 53 · Discontinued | $6.92 | $17.38 | $22.39 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $66.07 Typical High $83.18 | Professional | 54 · Surgery only | $25.70 | $66.07 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $13.18 Typical High $16.98 | Professional | 55 · Aftercare only | $5.13 | $13.18 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $8.71 Typical High $11.22 | Professional | 56 · Pre-op care only | $3.39 | $8.71 | $11.22 |
Where Texas sits
The same service costs 3.5 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· 34th of 51
$93.33
AK $229KY $66.07
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.