How much rates vary
Facilitymedian $891 · 10th to 90th $178 to $7,586Professionalmedian $141 · 10th to 90th $98 to $1,698
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 $645.65 Median $2,398.83 Typical High $6,918.31 | Facility | None | $645.65 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $125.89 | Professional | None | $97.72 | $107.15 | $125.89 |
BCBS Texas Setting Facility Modifier None Typical Low $5,623.41 Median $10,000.00 Typical High $19,498.45 | Facility | None | $5,623.41 | $10,000.00 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Christus Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $7,079.46 | Facility | None | $537.03 | $1,584.89 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $190.55 | Professional | None | $112.20 | $131.83 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $169.82 Median $2,344.23 Typical High $12,302.69 | Facility | None | $169.82 | $2,344.23 | $12,302.69 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $123.03 | Professional | None | $97.72 | $104.71 | $123.03 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $154.88 Median $758.58 Typical High $7,079.46 | Facility | None | $154.88 | $758.58 | $7,079.46 |
Providence Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $186.21 | Professional | None | $109.65 | $131.83 | $186.21 |
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 $93.33 Median $123.03 Typical High $186.21 | Professional | None | $93.33 | $123.03 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $48.98 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.38 Typical High $24.55 | Professional | 53 · Discontinued | $19.50 | $21.38 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 54 · Surgery only | $72.44 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $14.45 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $10.72 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 52 · Reduced service | $48.98 | $53.70 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $21.38 Typical High $24.55 | Professional | 53 · Discontinued | $19.50 | $21.38 | $24.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 54 · Surgery only | $72.44 | $81.28 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $16.22 Typical High $18.20 | Professional | 55 · Aftercare only | $14.45 | $16.22 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.72 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.77 | $10.72 | $12.30 |
Where Texas sits
The same service costs 4.0 times more in Alaska than in Delaware. 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· 22nd of 51
$162
AK $468DE $117
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.