How much rates vary
Facilitymedian $158 · 10th to 90th $76 to $2,138Professionalmedian $219 · 10th to 90th $54 to $1,738
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 $467.74 Median $2,187.76 Typical High $6,760.83 | Facility | None | $467.74 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $190.55 Typical High $323.59 | Professional | None | $75.86 | $190.55 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $199.53 Typical High $309.03 | Professional | None | $67.61 | $199.53 | $309.03 |
BCBS Texas Setting Facility Modifier None Typical Low $66.07 Median $134.90 Typical High $436.52 | Facility | None | $66.07 | $134.90 | $436.52 |
BCBS Texas Setting Professional Modifier None Typical Low $63.10 Median $194.98 Typical High $363.08 | Professional | None | $63.10 | $194.98 | $363.08 |
Christus Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $104.71 Typical High $1,412.54 | Facility | None | $74.13 | $104.71 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $316.23 | Professional | None | $79.43 | $199.53 | $316.23 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,737.80 | $1,737.80 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $102.33 Median $575.44 Typical High $4,168.69 | Facility | None | $102.33 | $575.44 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $75.86 Median $190.55 Typical High $331.13 | Professional | None | $75.86 | $190.55 | $331.13 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $213.80 Typical High $288.40 | Professional | None | $38.90 | $213.80 | $288.40 |
Providence Setting Facility Modifier None Typical Low $81.28 Median $309.03 Typical High $3,801.89 | Facility | None | $81.28 | $309.03 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $316.23 | Professional | None | $79.43 | $199.53 | $316.23 |
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 $67.61 Median $154.88 Typical High $281.84 | Professional | None | $67.61 | $154.88 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $38.02 Median $109.65 Typical High $144.54 | Professional | 52 · Reduced service | $38.02 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $15.14 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $56.23 | $162.18 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $11.22 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $7.59 | $21.88 | $28.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $109.65 Typical High $144.54 | Professional | 52 · Reduced service | $38.02 | $109.65 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $15.14 | $43.65 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $162.18 Typical High $213.80 | Professional | 54 · Surgery only | $56.23 | $162.18 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $11.22 | $33.11 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $7.59 | $21.88 | $28.84 |
Where Texas sits
The same service costs 9.4 times more in New York 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.
Physician feeFacility fee
NY $2,695MD $285
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.