How much rates vary
Facilitymedian $1,148 · 10th to 90th $380 to $4,169Professionalmedian $977 · 10th to 90th $214 to $7,244
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 $851.14 Median $2,570.40 Typical High $6,918.31 | Facility | None | $851.14 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,071.52 Typical High $1,445.44 | Professional | None | $263.03 | $1,071.52 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
BCBS Texas Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,949.84 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $251.19 Median $870.96 Typical High $1,513.56 | Professional | None | $251.19 | $870.96 | $1,513.56 |
Christus Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $645.65 Typical High $1,548.82 | Professional | None | $309.03 | $645.65 | $1,548.82 |
Lucent Health Setting Professional Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $9,332.54 | Professional | None | $7,244.36 | $7,244.36 | $9,332.54 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $6,025.60 | Facility | None | $457.09 | $1,995.26 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $1,071.52 Typical High $1,445.44 | Professional | None | $263.03 | $1,071.52 | $1,445.44 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $912.01 Typical High $1,148.15 | Professional | None | $158.49 | $912.01 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $3,981.07 | Professional | None | $870.96 | $954.99 | $3,981.07 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $1,023.29 Typical High $1,905.46 | Facility | None | $288.40 | $1,023.29 | $1,905.46 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $645.65 Typical High $1,548.82 | Professional | None | $309.03 | $645.65 | $1,548.82 |
United Setting Facility Modifier None Typical Low $177.83 Median $1,348.96 Typical High $2,691.53 | Facility | None | $177.83 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $239.88 Median $794.33 Typical High $1,659.59 | Professional | None | $239.88 | $794.33 | $1,659.59 |
Wellpoint Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
11 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 $131.83 Median $478.63 Typical High $691.83 | Professional | 52 · Reduced service | $131.83 | $478.63 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $52.48 | $194.98 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $724.44 Typical High $1,023.29 | Professional | 54 · Surgery only | $194.98 | $724.44 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $144.54 Typical High $204.17 | Professional | 55 · Aftercare only | $39.81 | $144.54 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $95.50 Typical High $138.04 | Professional | 56 · Pre-op care only | $26.30 | $95.50 | $138.04 |
Ambetter Setting Professional Modifier XU · Unusual separate service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | XU · Unusual separate service | $512.86 | $512.86 | $512.86 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $489.78 Typical High $691.83 | Professional | 52 · Reduced service | $131.83 | $489.78 | $691.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $52.48 | $194.98 | $275.42 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $741.31 Typical High $1,023.29 | Professional | 54 · Surgery only | $194.98 | $741.31 | $1,023.29 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $147.91 Typical High $204.17 | Professional | 55 · Aftercare only | $39.81 | $147.91 | $204.17 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $97.72 Typical High $138.04 | Professional | 56 · Pre-op care only | $26.30 | $97.72 | $138.04 |
Where Texas sits
The same service costs 3.5 times more in Wisconsin 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· 26th of 51
$977
WI $1,660MD $468
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.