How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,622 to $8,913Professionalmedian $891 · 10th to 90th $174 to $4,365
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 $194.98 Median $977.24 Typical High $1,348.96 | Professional | None | $194.98 | $977.24 | $1,348.96 |
Ambetter Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
BCBS Texas Setting Facility Modifier None Typical Low $2,630.27 Median $4,570.88 Typical High $10,232.93 | Facility | None | $2,630.27 | $4,570.88 | $10,232.93 |
BCBS Texas Setting Professional Modifier None Typical Low $186.21 Median $794.33 Typical High $1,380.38 | Professional | None | $186.21 | $794.33 | $1,380.38 |
Christus Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $575.44 Typical High $1,479.11 | Professional | None | $229.09 | $575.44 | $1,479.11 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $8,317.64 Typical High $8,317.64 | Professional | None | $6,760.83 | $8,317.64 | $8,317.64 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $1,995.26 Typical High $5,623.41 | Facility | None | $446.68 | $1,995.26 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $912.01 Typical High $1,348.96 | Professional | None | $194.98 | $912.01 | $1,348.96 |
Molina Setting Professional Modifier None Typical Low $144.54 Median $831.76 Typical High $1,047.13 | Professional | None | $144.54 | $831.76 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $912.01 Typical High $1,698.24 | Facility | None | $194.98 | $912.01 | $1,698.24 |
Providence Setting Professional Modifier None Typical Low $229.09 Median $588.84 Typical High $1,445.44 | Professional | None | $229.09 | $588.84 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $5,754.40 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,754.40 | $11,220.18 |
United Setting Professional Modifier None Typical Low $190.55 Median $794.33 Typical High $1,584.89 | Professional | None | $190.55 | $794.33 | $1,584.89 |
Wellpoint Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $97.72 Median $436.52 Typical High $645.65 | Professional | 52 · Reduced service | $97.72 | $436.52 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $173.78 Typical High $257.04 | Professional | 53 · Discontinued | $38.90 | $173.78 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $645.65 Typical High $954.99 | Professional | 54 · Surgery only | $144.54 | $645.65 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $128.82 Typical High $190.55 | Professional | 55 · Aftercare only | $28.84 | $128.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $87.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $19.50 | $87.10 | $128.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $436.52 Typical High $645.65 | Professional | 52 · Reduced service | $97.72 | $436.52 | $645.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $173.78 Typical High $257.04 | Professional | 53 · Discontinued | $38.90 | $173.78 | $257.04 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $645.65 Typical High $954.99 | Professional | 54 · Surgery only | $144.54 | $645.65 | $954.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $131.83 Typical High $190.55 | Professional | 55 · Aftercare only | $28.84 | $131.83 | $190.55 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $87.10 Typical High $128.82 | Professional | 56 · Pre-op care only | $19.50 | $87.10 | $128.82 |
Where Texas sits
The same service costs 5.9 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· 32nd of 51
$912
WI $1,622MD $275
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.