How much rates vary
Facilitymedian $3,090 · 10th to 90th $724 to $7,413Professionalmedian $186 · 10th to 90th $34 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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $275.42 | Professional | None | $128.82 | $208.93 | $275.42 |
BCBS Texas Setting Facility Modifier None Typical Low $2,570.40 Median $4,897.79 Typical High $10,471.29 | Facility | None | $2,570.40 | $4,897.79 | $10,471.29 |
BCBS Texas Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $269.15 | Professional | None | $123.03 | $199.53 | $269.15 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,089.30 Typical High $2,754.23 | Facility | None | $602.56 | $2,089.30 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $302.00 | Professional | None | $131.83 | $213.80 | $302.00 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $165.96 Median $1,122.02 Typical High $4,786.30 | Facility | None | $165.96 | $1,122.02 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $281.84 | Professional | None | $128.82 | $199.53 | $281.84 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $162.18 Typical High $218.78 | Professional | None | $28.84 | $162.18 | $218.78 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $1,995.26 Typical High $4,466.84 | Facility | None | $223.87 | $1,995.26 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $302.00 | Professional | None | $131.83 | $213.80 | $302.00 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $281.84 | Professional | None | $112.20 | $177.83 | $281.84 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $25.70 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $95.50 | $141.25 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $95.50 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $95.50 | $123.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $50.12 | Professional | 53 · Discontinued | $25.70 | $38.02 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $186.21 | Professional | 54 · Surgery only | $95.50 | $141.25 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $25.12 |
Where Texas sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 41st of 51
$219
AK $708KY $191
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.