How much rates vary
Facilitymedian $1,288 · 10th to 90th $646 to $3,981Professionalmedian $240 · 10th to 90th $54 to $468
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 $630.96 Median $2,570.40 Typical High $6,918.31 | Facility | None | $630.96 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $354.81 | Professional | None | $165.96 | $245.47 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
BCBS Texas Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $3,981.07 | Facility | None | $758.58 | $1,548.82 | $3,981.07 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $398.11 | Professional | None | $138.04 | $208.93 | $398.11 |
Baylor Scott & White Setting Facility Modifier None Typical Low $162.18 Median $1,905.46 Typical High $4,073.80 | Facility | None | $162.18 | $1,905.46 | $4,073.80 |
Christus Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,047.13 Typical High $1,659.59 | Facility | None | $457.09 | $1,047.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
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 $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $1,905.46 Typical High $5,248.07 | Facility | None | $245.47 | $1,905.46 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $354.81 | Professional | None | $165.96 | $245.47 | $354.81 |
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 $288.40 Median $1,096.48 Typical High $3,801.89 | Facility | None | $288.40 | $1,096.48 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $436.52 | Professional | None | $169.82 | $263.03 | $436.52 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,137.96 Typical High $3,981.07 | Facility | None | $616.60 | $2,137.96 | $3,981.07 |
United Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $398.11 | Professional | None | $147.91 | $234.42 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
13 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 $83.18 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $83.18 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $33.11 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $123.03 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $24.55 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.60 | $22.39 | $28.84 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 50 · Both sides | $208.93 | $208.93 | $208.93 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $1,288.25 Median $2,951.21 Typical High $4,265.80 | Facility | 50 · Both sides | $1,288.25 | $2,951.21 | $4,265.80 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $295.12 Typical High $562.34 | Professional | 50 · Both sides | $186.21 | $295.12 | $562.34 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $112.20 Typical High $144.54 | Professional | 52 · Reduced service | $83.18 | $112.20 | $144.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $44.67 Typical High $57.54 | Professional | 53 · Discontinued | $33.11 | $44.67 | $57.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $123.03 | $169.82 | $213.80 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $24.55 | $33.88 | $42.66 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $22.39 Typical High $28.84 | Professional | 56 · Pre-op care only | $16.60 | $22.39 | $28.84 |
Where Texas sits
The same service costs 3.1 times more in Alaska than in New York. 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· 46th of 51
$269
AK $794NY $257
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.