How much rates vary
Facilitymedian $1,047 · 10th to 90th $100 to $4,074Professionalmedian $32 · 10th to 90th $22 to $2,692
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 $524.81 Median $2,238.72 Typical High $6,918.31 | Facility | None | $524.81 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $34.67 | Professional | None | $19.05 | $24.55 | $34.67 |
Ambetter Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
BCBS Texas Setting Facility Modifier None Typical Low $104.71 Median $1,949.84 Typical High $4,073.80 | Facility | None | $104.71 | $1,949.84 | $4,073.80 |
BCBS Texas Setting Professional Modifier None Typical Low $22.39 Median $31.62 Typical High $50.12 | Professional | None | $22.39 | $31.62 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,584.89 Typical High $2,691.53 | Facility | None | $457.09 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $45.71 | Professional | None | $23.99 | $33.11 | $45.71 |
Lucent Health Setting Professional Modifier None Typical Low $2,691.53 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,691.53 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $24.55 Median $1,096.48 Typical High $4,786.30 | Facility | None | $24.55 | $1,096.48 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $35.48 | Professional | None | $19.05 | $24.55 | $35.48 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $23.99 Typical High $27.54 | Professional | None | $19.95 | $23.99 | $27.54 |
Providence Setting Facility Modifier None Typical Low $22.91 Median $467.74 Typical High $2,691.53 | Facility | None | $22.91 | $467.74 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $23.99 Median $33.11 Typical High $45.71 | Professional | None | $23.99 | $33.11 | $45.71 |
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 $21.88 Median $30.20 Typical High $46.77 | Professional | None | $21.88 | $30.20 | $46.77 |
Wellpoint Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $9.55 Median $12.30 Typical High $15.49 | Professional | 52 · Reduced service | $9.55 | $12.30 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $5.01 Typical High $6.17 | Professional | 53 · Discontinued | $3.80 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $18.62 Typical High $23.44 | Professional | 54 · Surgery only | $14.13 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.72 Typical High $4.68 | Professional | 55 · Aftercare only | $2.82 | $3.72 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.45 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.91 | $2.45 | $3.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $12.30 Typical High $15.49 | Professional | 52 · Reduced service | $9.55 | $12.30 | $15.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $5.01 Typical High $6.17 | Professional | 53 · Discontinued | $3.80 | $5.01 | $6.17 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $18.62 Typical High $22.91 | Professional | 54 · Surgery only | $14.13 | $18.62 | $22.91 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.72 Typical High $4.68 | Professional | 55 · Aftercare only | $2.82 | $3.72 | $4.68 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.45 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.91 | $2.45 | $3.09 |
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· 30th of 51
$34.67
AK $100NJ $28.84
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.