How much rates vary
Facilitymedian $891 · 10th to 90th $240 to $4,074Professionalmedian $269 · 10th to 90th $62 to $2,818
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 $69.18 Median $208.93 Typical High $354.81 | Professional | None | $69.18 | $208.93 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $79.43 | Professional | None | $64.57 | $64.57 | $79.43 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,659.59 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $77.62 Median $213.80 Typical High $457.09 | Professional | None | $77.62 | $213.80 | $457.09 |
Christus Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $199.53 Typical High $407.38 | Professional | None | $87.10 | $199.53 | $407.38 |
Health Smart Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Lucent Health Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $1,479.11 Typical High $4,570.88 | Facility | None | $239.88 | $1,479.11 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $213.80 Typical High $354.81 | Professional | None | $69.18 | $213.80 | $354.81 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $257.04 Typical High $323.59 | Professional | None | $44.67 | $257.04 | $323.59 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $281.84 Typical High $501.19 | Facility | None | $75.86 | $281.84 | $501.19 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $204.17 Typical High $407.38 | Professional | None | $87.10 | $204.17 | $407.38 |
United Setting Facility Modifier None Typical Low $177.83 Median $1,348.96 Typical High $2,691.53 | Facility | None | $177.83 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $72.44 Median $194.98 Typical High $380.19 | Professional | None | $72.44 | $194.98 | $380.19 |
Wellpoint Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $34.67 Median $102.33 Typical High $169.82 | Professional | 52 · Reduced service | $34.67 | $102.33 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $40.74 Typical High $67.61 | Professional | 53 · Discontinued | $13.80 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $154.88 Typical High $251.19 | Professional | 54 · Surgery only | $52.48 | $154.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $30.90 Typical High $50.12 | Professional | 55 · Aftercare only | $10.23 | $30.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $20.42 Typical High $33.88 | Professional | 56 · Pre-op care only | $6.92 | $20.42 | $33.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $33.88 | $117.49 | $169.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $13.80 | $46.77 | $67.61 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $177.83 Typical High $251.19 | Professional | 54 · Surgery only | $51.29 | $177.83 | $251.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $35.48 Typical High $50.12 | Professional | 55 · Aftercare only | $10.23 | $35.48 | $50.12 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $6.92 | $23.44 | $33.88 |
Where Texas sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 17th of 51
$282
WA $447VA $107
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.