How much rates vary
Facilitymedian $708 · 10th to 90th $98 to $3,236Professionalmedian $85 · 10th to 90th $19 to $182
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $131.83 | Professional | None | $40.74 | $74.13 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $181.97 | Professional | None | $87.10 | $87.10 | $181.97 |
BCBS Texas Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $1,819.70 | Facility | None | $323.59 | $645.65 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $50.12 Median $85.11 Typical High $144.54 | Professional | None | $50.12 | $85.11 | $144.54 |
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 $53.70 Median $89.13 Typical High $125.89 | Professional | None | $53.70 | $89.13 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | None | $676.08 | $676.08 | $831.76 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $891.25 Typical High $4,570.88 | Facility | None | $70.79 | $891.25 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $131.83 | Professional | None | $40.74 | $74.13 | $131.83 |
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 $70.79 Typical High $194.98 | Facility | None | $50.12 | $70.79 | $194.98 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $125.89 | Professional | None | $53.70 | $89.13 | $125.89 |
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 $48.98 Median $79.43 Typical High $123.03 | Professional | None | $48.98 | $79.43 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $20.42 Median $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $20.42 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $14.13 Typical High $17.78 | Professional | 53 · Discontinued | $8.13 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $52.48 Typical High $66.07 | Professional | 54 · Surgery only | $30.90 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $13.18 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $8.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $20.42 | $34.67 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $14.13 Typical High $17.78 | Professional | 53 · Discontinued | $8.13 | $14.13 | $17.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $52.48 Typical High $66.07 | Professional | 54 · Surgery only | $30.90 | $52.48 | $66.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $13.18 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $8.71 |
Where Texas sits
The same service costs 3.2 times more in Alaska than in New York. 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· 44th of 51
$89.13
AK $245NY $77.62
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.