How much rates vary
Facilitymedian $263 · 10th to 90th $34 to $2,570Professionalmedian $60 · 10th to 90th $35 to $120
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 $60.26 Median $2,089.30 Typical High $6,760.83 | Facility | None | $60.26 | $2,089.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $83.18 | Professional | None | $37.15 | $54.95 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $75.86 | Professional | None | $38.90 | $58.88 | $75.86 |
BCBS Texas Setting Facility Modifier None Typical Low $28.84 Median $43.65 Typical High $275.42 | Facility | None | $28.84 | $43.65 | $275.42 |
BCBS Texas Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $91.20 | Professional | None | $39.81 | $57.54 | $91.20 |
Baylor Scott & White Setting Professional Modifier None Typical Low $38.90 Median $66.07 Typical High $104.71 | Professional | None | $38.90 | $66.07 | $104.71 |
Christus Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $54.95 Typical High $1,412.54 | Facility | None | $39.81 | $54.95 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $66.07 Typical High $91.20 | Professional | None | $48.98 | $66.07 | $91.20 |
Health Smart Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $120.23 | Professional | None | $79.43 | $95.50 | $120.23 |
Lucent Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $776.25 Typical High $3,801.89 | Facility | None | $81.28 | $776.25 | $3,801.89 |
Moda Health Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $91.20 | Professional | None | $37.15 | $54.95 | $91.20 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $54.95 Typical High $74.13 | Professional | None | $10.00 | $54.95 | $74.13 |
Oscar Health Setting Facility Modifier None Typical Low $36.31 Median $42.66 Typical High $1,778.28 | Facility | None | $36.31 | $42.66 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $154.88 Typical High $257.04 | Professional | None | $144.54 | $154.88 | $257.04 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $81.28 Typical High $3,801.89 | Facility | None | $43.65 | $81.28 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $91.20 | Professional | None | $47.86 | $64.57 | $91.20 |
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 $38.90 Median $54.95 Typical High $87.10 | Professional | None | $38.90 | $54.95 | $87.10 |
Wellpoint Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
15 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 $18.62 Median $27.54 Typical High $34.67 | Professional | 52 · Reduced service | $18.62 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.96 Typical High $13.80 | Professional | 53 · Discontinued | $7.41 | $10.96 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $40.74 Typical High $52.48 | Professional | 54 · Surgery only | $28.18 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $5.62 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.50 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.72 | $5.50 | $6.92 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $67.61 Median $95.50 Typical High $104.71 | Professional | 50 · Both sides | $67.61 | $95.50 | $104.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | 59 · Distinct service | $53.70 | $53.70 | $58.88 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $446.68 Median $812.83 Typical High $3,467.37 | Facility | 50 · Both sides | $446.68 | $812.83 | $3,467.37 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $100.00 Typical High $186.21 | Professional | 50 · Both sides | $63.10 | $100.00 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $18.62 | $27.54 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $7.41 | $10.96 | $13.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $40.74 Typical High $50.12 | Professional | 54 · Surgery only | $28.18 | $40.74 | $50.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $5.62 | $8.32 | $10.00 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.72 | $5.50 | $6.61 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $23.44 Median $74.13 Typical High $120.23 | Professional | 59 · Distinct service | $23.44 | $74.13 | $120.23 |
Where Texas sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 49th of 51
$60.26
AK $224FL $53.70
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.