How much rates vary
Facilitymedian $1,148 · 10th to 90th $123 to $4,169Professionalmedian $204 · 10th to 90th $45 to $1,738
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 $549.54 Median $2,570.40 Typical High $6,918.31 | Facility | None | $549.54 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $257.04 | Professional | None | $74.13 | $190.55 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $204.17 | Professional | None | $74.13 | $158.49 | $204.17 |
BCBS Texas Setting Facility Modifier None Typical Low $575.44 Median $1,122.02 Typical High $3,162.28 | Facility | None | $575.44 | $1,122.02 | $3,162.28 |
BCBS Texas Setting Professional Modifier None Typical Low $91.20 Median $213.80 Typical High $363.08 | Professional | None | $91.20 | $213.80 | $363.08 |
Baylor Scott & White Setting Facility Modifier None Typical Low $263.03 Median $1,659.59 Typical High $2,818.38 | Facility | None | $263.03 | $1,659.59 | $2,818.38 |
Christus Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $912.01 Typical High $1,659.59 | Facility | None | $501.19 | $912.01 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $218.78 Typical High $346.74 | Professional | None | $102.33 | $218.78 | $346.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,737.80 | $2,041.74 | $2,041.74 |
Moda Health Setting Facility Modifier None Typical Low $257.04 Median $1,698.24 Typical High $5,128.61 | Facility | None | $257.04 | $1,698.24 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $74.13 Median $181.97 Typical High $257.04 | Professional | None | $74.13 | $181.97 | $257.04 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $186.21 Typical High $251.19 | Professional | None | $33.88 | $186.21 | $251.19 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $1,584.89 Typical High $3,981.07 | Facility | None | $125.89 | $1,584.89 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $346.74 | Professional | None | $102.33 | $223.87 | $346.74 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $3,801.89 | Facility | None | $616.60 | $2,137.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $89.13 Median $181.97 Typical High $338.84 | Professional | None | $89.13 | $181.97 | $338.84 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $37.15 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $37.15 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $15.14 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $134.90 Typical High $177.83 | Professional | 54 · Surgery only | $56.23 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $26.92 Typical High $35.48 | Professional | 55 · Aftercare only | $11.22 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.41 | $18.20 | $23.44 |
Moda Health Setting Facility Modifier XP · Separate practitioner Typical Low $676.08 Median $1,202.26 Typical High $2,570.40 | Facility | XP · Separate practitioner | $676.08 | $1,202.26 | $2,570.40 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $91.20 Typical High $114.82 | Professional | 52 · Reduced service | $37.15 | $91.20 | $114.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $15.14 | $36.31 | $45.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $56.23 | $134.90 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $11.22 | $26.92 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $18.20 Typical High $22.91 | Professional | 56 · Pre-op care only | $7.41 | $18.20 | $22.91 |
Where Texas sits
The same service costs 7.3 times more in Vermont than in Montana. 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
VT $3,341MT $455
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.