How much rates vary
Facilitymedian $269 · 10th to 90th $100 to $2,291Professionalmedian $63 · 10th to 90th $14 to $132
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 $83.18 Median $2,187.76 Typical High $6,760.83 | Facility | None | $83.18 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $69.18 Typical High $114.82 | Professional | None | $28.18 | $69.18 | $114.82 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $79.43 Typical High $89.13 | Professional | None | $34.67 | $79.43 | $89.13 |
BCBS Texas Setting Facility Modifier None Typical Low $144.54 Median $281.84 Typical High $1,513.56 | Facility | None | $144.54 | $281.84 | $1,513.56 |
BCBS Texas Setting Professional Modifier None Typical Low $30.90 Median $66.07 Typical High $120.23 | Professional | None | $30.90 | $66.07 | $120.23 |
Baylor Scott & White Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Baylor Scott & White Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $147.91 | Professional | None | $100.00 | $100.00 | $147.91 |
Christus Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
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 $35.48 Median $70.79 Typical High $114.82 | Professional | None | $35.48 | $70.79 | $114.82 |
Lucent Health Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $776.25 | Professional | None | $602.56 | $602.56 | $776.25 |
Moda Health Setting Facility Modifier None Typical Low $48.98 Median $371.54 Typical High $3,715.35 | Facility | None | $48.98 | $371.54 | $3,715.35 |
Moda Health Setting Professional Modifier None Typical Low $28.18 Median $70.79 Typical High $120.23 | Professional | None | $28.18 | $70.79 | $120.23 |
Molina Setting Professional Modifier None Typical Low $9.55 Median $53.70 Typical High $72.44 | Professional | None | $9.55 | $53.70 | $72.44 |
Oscar Health Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
Providence Setting Facility Modifier None Typical Low $34.67 Median $66.07 Typical High $338.84 | Facility | None | $34.67 | $66.07 | $338.84 |
Providence Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $114.82 | Professional | None | $35.48 | $70.79 | $114.82 |
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 $30.90 Median $61.66 Typical High $100.00 | Professional | None | $30.90 | $61.66 | $100.00 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
11 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 $14.13 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $14.13 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $13.49 Typical High $16.98 | Professional | 53 · Discontinued | $5.62 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $51.29 Typical High $64.57 | Professional | 54 · Surgery only | $20.89 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $10.23 Typical High $12.88 | Professional | 55 · Aftercare only | $4.27 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $6.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $2.82 | $6.76 | $8.51 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $70.79 Median $79.43 Typical High $91.20 | Professional | 59 · Distinct service | $70.79 | $79.43 | $91.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $14.13 | $33.88 | $42.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $13.49 Typical High $16.98 | Professional | 53 · Discontinued | $5.62 | $13.49 | $16.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $50.12 Typical High $64.57 | Professional | 54 · Surgery only | $20.89 | $50.12 | $64.57 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $10.23 Typical High $12.88 | Professional | 55 · Aftercare only | $4.27 | $10.23 | $12.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.31 | $7.08 | $8.71 |
Where Texas sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 38th of 51
$70.79
AK $178KY $47.86
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.