How much rates vary
Facilitymedian $8,511 · 10th to 90th $2,884 to $16,982Professionalmedian $3,548 · 10th to 90th $85 to $29,512
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 $645.65 Median $2,398.83 Typical High $6,918.31 | Facility | None | $645.65 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $2,691.53 Typical High $5,754.40 | Professional | None | $85.11 | $2,691.53 | $5,754.40 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $3,715.35 Typical High $3,801.89 | Professional | None | $74.13 | $3,715.35 | $3,801.89 |
BCBS Texas Setting Facility Modifier None Typical Low $4,677.35 Median $8,317.64 Typical High $19,498.45 | Facility | None | $4,677.35 | $8,317.64 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $70.79 Median $2,884.03 Typical High $5,754.40 | Professional | None | $70.79 | $2,884.03 | $5,754.40 |
Christus Setting Facility Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Facility | None | $8,511.38 | $8,511.38 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $8,912.51 Typical High $14,125.38 | Facility | None | $758.58 | $8,912.51 | $14,125.38 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $6,918.31 | Professional | None | $93.33 | $194.98 | $6,918.31 |
Lucent Health Setting Professional Modifier None Typical Low $29,512.09 Median $34,673.69 Typical High $34,673.69 | Professional | None | $29,512.09 | $34,673.69 | $34,673.69 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $6,025.60 Typical High $16,595.87 | Facility | None | $549.54 | $6,025.60 | $16,595.87 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $3,311.31 Typical High $6,025.60 | Professional | None | $85.11 | $3,311.31 | $6,025.60 |
Molina Setting Professional Modifier None Typical Low $575.44 Median $3,162.28 Typical High $4,365.16 | Professional | None | $575.44 | $3,162.28 | $4,365.16 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $8,511.38 Typical High $14,125.38 | Facility | None | $478.63 | $8,511.38 | $14,125.38 |
Providence Setting Professional Modifier None Typical Low $93.33 Median $204.17 Typical High $6,918.31 | Professional | None | $93.33 | $204.17 | $6,918.31 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $9,772.37 Typical High $19,952.62 | Facility | None | $3,981.07 | $9,772.37 | $19,952.62 |
United Setting Professional Modifier None Typical Low $79.43 Median $2,884.03 Typical High $7,762.47 | Professional | None | $79.43 | $2,884.03 | $7,762.47 |
Wellpoint Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $42.66 Median $199.53 Typical High $2,630.27 | Professional | 52 · Reduced service | $42.66 | $199.53 | $2,630.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $81.28 Typical High $1,071.52 | Professional | 53 · Discontinued | $16.98 | $81.28 | $1,071.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $302.00 Typical High $3,981.07 | Professional | 54 · Surgery only | $64.57 | $302.00 | $3,981.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $60.26 Typical High $794.33 | Professional | 55 · Aftercare only | $12.88 | $60.26 | $794.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $489.78 Typical High $575.44 | Professional | 56 · Pre-op care only | $9.55 | $489.78 | $575.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $199.53 Typical High $2,630.27 | Professional | 52 · Reduced service | $42.66 | $199.53 | $2,630.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $81.28 Typical High $1,071.52 | Professional | 53 · Discontinued | $16.98 | $81.28 | $1,071.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $302.00 Typical High $3,981.07 | Professional | 54 · Surgery only | $64.57 | $302.00 | $3,981.07 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $60.26 Typical High $794.33 | Professional | 55 · Aftercare only | $12.88 | $60.26 | $794.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $489.78 Typical High $602.56 | Professional | 56 · Pre-op care only | $11.22 | $489.78 | $602.56 |
Where Texas sits
The same service costs 6.2 times more in Alaska than in Vermont. 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
AK $20,033VT $3,256
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.