How much rates vary
Facilitymedian $2,188 · 10th to 90th $316 to $6,457Professionalmedian $1,738 · 10th to 90th $316 to $13,183
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 $316.23 Median $1,698.24 Typical High $2,398.83 | Professional | None | $316.23 | $1,698.24 | $2,398.83 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $295.12 Typical High $295.12 | Professional | None | $147.91 | $295.12 | $295.12 |
BCBS Texas Setting Facility Modifier None Typical Low $3,162.28 Median $6,606.93 Typical High $6,760.83 | Facility | None | $3,162.28 | $6,606.93 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $316.23 Median $1,148.15 Typical High $2,630.27 | Professional | None | $316.23 | $1,148.15 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $831.76 Typical High $2,630.27 | Professional | None | $371.54 | $831.76 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $13,182.57 Median $13,182.57 Typical High $17,378.01 | Professional | None | $13,182.57 | $13,182.57 | $17,378.01 |
Moda Health Setting Facility Modifier None Typical Low $575.44 Median $2,570.40 Typical High $5,128.61 | Facility | None | $575.44 | $2,570.40 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $316.23 Median $1,548.82 Typical High $2,398.83 | Professional | None | $316.23 | $1,548.82 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $295.12 Median $1,698.24 Typical High $2,187.76 | Professional | None | $295.12 | $1,698.24 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $7,244.36 | Professional | None | $1,096.48 | $1,202.26 | $7,244.36 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $1,862.09 Typical High $3,019.95 | Facility | None | $354.81 | $1,862.09 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $389.05 Median $891.25 Typical High $2,630.27 | Professional | None | $389.05 | $891.25 | $2,630.27 |
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 $295.12 Median $1,174.90 Typical High $2,754.23 | Professional | None | $295.12 | $1,174.90 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $158.49 Median $741.31 Typical High $1,148.15 | Professional | 52 · Reduced service | $158.49 | $741.31 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $309.03 Typical High $457.09 | Professional | 53 · Discontinued | $63.10 | $309.03 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $1,096.48 Typical High $1,698.24 | Professional | 54 · Surgery only | $239.88 | $1,096.48 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $218.78 Typical High $346.74 | Professional | 55 · Aftercare only | $47.86 | $218.78 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $147.91 Typical High $229.09 | Professional | 56 · Pre-op care only | $31.62 | $147.91 | $229.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $776.25 Typical High $1,148.15 | Professional | 52 · Reduced service | $158.49 | $776.25 | $1,148.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $309.03 Typical High $457.09 | Professional | 53 · Discontinued | $63.10 | $309.03 | $457.09 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $1,174.90 Typical High $1,698.24 | Professional | 54 · Surgery only | $239.88 | $1,174.90 | $1,698.24 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $234.42 Typical High $338.84 | Professional | 55 · Aftercare only | $47.86 | $234.42 | $338.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $154.88 Typical High $229.09 | Professional | 56 · Pre-op care only | $31.62 | $154.88 | $229.09 |
Where Texas sits
The same service costs 5.5 times more in Washington 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· 21st of 51
$1,738
WA $2,818KY $513
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.