How much rates vary
Facilitymedian $288 · 10th to 90th $56 to $2,042Professionalmedian $102 · 10th to 90th $35 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 $52.48 Median $1,819.70 Typical High $6,918.31 | Facility | None | $52.48 | $1,819.70 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $151.36 | Professional | None | $43.65 | $87.10 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $147.91 | Professional | None | $51.29 | $85.11 | $147.91 |
BCBS Texas Setting Facility Modifier None Typical Low $144.54 Median $302.00 Typical High $1,548.82 | Facility | None | $144.54 | $302.00 | $1,548.82 |
BCBS Texas Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $173.78 | Professional | None | $50.12 | $93.33 | $173.78 |
Christus Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
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 $57.54 Median $107.15 Typical High $147.91 | Professional | None | $57.54 | $107.15 | $147.91 |
Health Smart Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $199.53 | Professional | None | $79.43 | $141.25 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,202.26 | Professional | None | $954.99 | $954.99 | $1,202.26 |
Moda Health Setting Facility Modifier None Typical Low $87.10 Median $363.08 Typical High $3,235.94 | Facility | None | $87.10 | $363.08 | $3,235.94 |
Moda Health Setting Professional Modifier None Typical Low $43.65 Median $87.10 Typical High $162.18 | Professional | None | $43.65 | $87.10 | $162.18 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $147.91 | Professional | None | $19.50 | $107.15 | $147.91 |
Oscar Health Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $489.78 | Facility | None | $398.11 | $489.78 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $295.12 | Professional | None | $66.07 | $141.25 | $295.12 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $338.84 | Facility | None | $50.12 | $77.62 | $338.84 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $147.91 | Professional | None | $57.54 | $102.33 | $147.91 |
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 $51.29 Median $91.20 Typical High $151.36 | Professional | None | $51.29 | $91.20 | $151.36 |
Wellpoint Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $21.88 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $21.88 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $8.71 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $63.10 Typical High $79.43 | Professional | 54 · Surgery only | $32.36 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.88 Typical High $16.22 | Professional | 55 · Aftercare only | $6.46 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $8.51 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.37 | $8.51 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $42.66 Typical High $53.70 | Professional | 52 · Reduced service | $21.88 | $42.66 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $8.71 | $16.98 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $63.10 Typical High $79.43 | Professional | 54 · Surgery only | $32.36 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.88 Typical High $16.22 | Professional | 55 · Aftercare only | $6.46 | $12.88 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.71 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.25 | $8.71 | $10.96 |
Where Texas sits
The same service costs 12.9 times more in Colorado than in Maine. 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.
Physician feeFacility fee
CO $2,408ME $187
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.