How much rates vary
Facilitymedian $275 · 10th to 90th $123 to $2,884Professionalmedian $234 · 10th to 90th $47 to $1,862
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $263.03 | Professional | None | $131.83 | $208.93 | $263.03 |
BCBS Texas Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $1,230.27 | Facility | None | $114.82 | $199.53 | $1,230.27 |
BCBS Texas Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $398.11 | Professional | None | $151.36 | $239.88 | $398.11 |
Christus Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $186.21 Typical High $269.15 | Facility | None | $66.07 | $186.21 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $331.13 | Professional | None | $169.82 | $239.88 | $331.13 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,862.09 | $1,862.09 | $2,454.71 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $1,000.00 Typical High $4,786.30 | Facility | None | $177.83 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $263.03 | Professional | None | $131.83 | $208.93 | $263.03 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $218.78 Typical High $295.12 | Professional | None | $38.90 | $218.78 | $295.12 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $323.59 | Facility | None | $66.07 | $199.53 | $323.59 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $331.13 | Professional | None | $169.82 | $234.42 | $331.13 |
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 $131.83 Median $194.98 Typical High $302.00 | Professional | None | $131.83 | $194.98 | $302.00 |
Wellpoint Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $64.57 Median $102.33 Typical High $128.82 | Professional | 52 · Reduced service | $64.57 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $41.69 Typical High $52.48 | Professional | 53 · Discontinued | $26.30 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $154.88 Typical High $194.98 | Professional | 54 · Surgery only | $97.72 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $102.33 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $26.30 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $97.72 | $154.88 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $19.50 | $30.90 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $25.12 |
Where Texas sits
The same service costs 3.9 times more in Alaska than in Maryland. 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· 35th of 51
$234
AK $692MD $178
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.