How much rates vary
Facilitymedian $115 · 10th to 90th $14 to $2,512Professionalmedian $11 · 10th to 90th $6 to $26
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 $12.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $12.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $10.23 Typical High $21.88 | Professional | None | $5.37 | $10.23 | $21.88 |
Ambetter Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | None | $10.47 | $10.47 | $10.47 |
BCBS Texas Setting Facility Modifier None Typical Low $52.48 Median $100.00 Typical High $478.63 | Facility | None | $52.48 | $100.00 | $478.63 |
BCBS Texas Setting Professional Modifier None Typical Low $6.03 Median $11.75 Typical High $20.89 | Professional | None | $6.03 | $11.75 | $20.89 |
Christus Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
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 $7.08 Median $12.88 Typical High $19.05 | Professional | None | $7.08 | $12.88 | $19.05 |
Lucent Health Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Moda Health Setting Facility Modifier None Typical Low $6.92 Median $181.97 Typical High $5,128.61 | Facility | None | $6.92 | $181.97 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $5.37 Median $10.23 Typical High $21.88 | Professional | None | $5.37 | $10.23 | $21.88 |
Molina Setting Professional Modifier None Typical Low $5.62 Median $7.08 Typical High $12.02 | Professional | None | $5.62 | $7.08 | $12.02 |
Providence Setting Facility Modifier None Typical Low $6.92 Median $27.54 Typical High $151.36 | Facility | None | $6.92 | $27.54 | $151.36 |
Providence Setting Professional Modifier None Typical Low $6.92 Median $12.88 Typical High $19.05 | Professional | None | $6.92 | $12.88 | $19.05 |
United Setting Facility Modifier None Typical Low $138.04 Median $741.31 Typical High $2,187.76 | Facility | None | $138.04 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $6.31 Median $11.22 Typical High $19.95 | Professional | None | $6.31 | $11.22 | $19.95 |
Wellpoint Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
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 $2.69 Median $5.01 Typical High $6.03 | Professional | 52 · Reduced service | $2.69 | $5.01 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $2.00 Typical High $2.40 | Professional | 53 · Discontinued | $1.07 | $2.00 | $2.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.07 Median $7.41 Typical High $9.12 | Professional | 54 · Surgery only | $4.07 | $7.41 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $1.51 Typical High $1.82 | Professional | 55 · Aftercare only | $0.81 | $1.51 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $1.00 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.54 | $1.00 | $1.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $2.69 Median $5.13 Typical High $5.89 | Professional | 52 · Reduced service | $2.69 | $5.13 | $5.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $2.04 Typical High $2.40 | Professional | 53 · Discontinued | $1.07 | $2.04 | $2.40 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $4.07 Median $7.41 Typical High $8.91 | Professional | 54 · Surgery only | $4.07 | $7.41 | $8.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $1.51 Typical High $1.82 | Professional | 55 · Aftercare only | $0.81 | $1.51 | $1.82 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $1.02 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.54 | $1.02 | $1.20 |
Where Texas sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 43rd of 51
$13.49
AK $38.90NJ $11.22
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.