How much rates vary
Facilitymedian $234 · 10th to 90th $74 to $3,467Professionalmedian $120 · 10th to 90th $23 to $562
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $204.17 | Professional | None | $69.18 | $109.65 | $204.17 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $147.91 | Professional | None | $117.49 | $138.04 | $147.91 |
BCBS Texas Setting Facility Modifier None Typical Low $72.44 Median $107.15 Typical High $691.83 | Facility | None | $72.44 | $107.15 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $213.80 | Professional | None | $74.13 | $117.49 | $213.80 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $1,412.54 | Facility | None | $79.43 | $112.20 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $194.98 | Professional | None | $89.13 | $138.04 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $97.72 Median $977.24 Typical High $4,365.16 | Facility | None | $97.72 | $977.24 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $204.17 | Professional | None | $69.18 | $114.82 | $204.17 |
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 $87.10 Median $158.49 Typical High $3,801.89 | Facility | None | $87.10 | $158.49 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $194.98 | Professional | None | $89.13 | $138.04 | $194.98 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,090.30 | Facility | None | $389.05 | $1,230.27 | $3,090.30 |
United Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $186.21 | Professional | None | $79.43 | $120.23 | $186.21 |
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 $34.67 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $34.67 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $13.80 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $102.33 | Professional | 54 · Surgery only | $52.48 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $10.47 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.96 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.92 | $10.96 | $13.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $34.67 | $54.95 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.88 Typical High $27.54 | Professional | 53 · Discontinued | $13.80 | $21.88 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $102.33 | Professional | 54 · Surgery only | $52.48 | $83.18 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.60 Typical High $20.42 | Professional | 55 · Aftercare only | $10.47 | $16.60 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.96 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.92 | $10.96 | $13.80 |
Where Texas sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 47th of 51
$126
AK $372FL $117
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.