How much rates vary
Facilitymedian $155 · 10th to 90th $38 to $2,291Professionalmedian $59 · 10th to 90th $13 to $93
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 $512.86 Median $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $54.95 Typical High $77.62 | Professional | None | $33.88 | $54.95 | $77.62 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
BCBS Texas Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $331.13 | Facility | None | $33.11 | $50.12 | $331.13 |
BCBS Texas Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $95.50 | Professional | None | $38.02 | $60.26 | $95.50 |
Baylor Scott & White Setting Facility Modifier None Typical Low $39.81 Median $309.03 Typical High $426.58 | Facility | None | $39.81 | $309.03 | $426.58 |
Baylor Scott & White Setting Professional Modifier None Typical Low $36.31 Median $41.69 Typical High $52.48 | Professional | None | $36.31 | $41.69 | $52.48 |
Christus Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $60.26 Typical High $1,412.54 | Facility | None | $41.69 | $60.26 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $83.18 | Professional | None | $43.65 | $63.10 | $83.18 |
Lucent Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $46.77 Median $741.31 Typical High $4,265.80 | Facility | None | $46.77 | $741.31 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $54.95 Typical High $81.28 | Professional | None | $33.88 | $54.95 | $81.28 |
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 Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $251.19 | Professional | None | $131.83 | $141.25 | $251.19 |
Providence Setting Facility Modifier None Typical Low $45.71 Median $79.43 Typical High $3,801.89 | Facility | None | $45.71 | $79.43 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $83.18 | Professional | None | $43.65 | $63.10 | $83.18 |
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 $34.67 Median $51.29 Typical High $75.86 | Professional | None | $34.67 | $51.29 | $75.86 |
Wellpoint Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $16.98 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $16.98 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.96 Typical High $13.49 | Professional | 53 · Discontinued | $6.92 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $40.74 Typical High $50.12 | Professional | 54 · Surgery only | $25.70 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $5.13 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.39 | $5.50 | $6.61 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $16.98 | $27.54 | $33.11 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.96 Typical High $13.18 | Professional | 53 · Discontinued | $6.92 | $10.96 | $13.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $40.74 Typical High $48.98 | Professional | 54 · Surgery only | $25.70 | $40.74 | $48.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.13 Typical High $9.77 | Professional | 55 · Aftercare only | $5.13 | $8.13 | $9.77 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.50 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.39 | $5.50 | $6.61 |
Where Texas sits
The same service costs 3.5 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· 42nd of 51
$58.88
AK $178FL $51.29
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.