How much rates vary
Facilitymedian $5,495 · 10th to 90th $2,344 to $13,490Professionalmedian $1,862 · 10th to 90th $347 to $3,981
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 $870.96 Median $3,235.94 Typical High $8,511.38 | Facility | None | $870.96 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $2,691.53 | Professional | None | $346.74 | $1,584.89 | $2,691.53 |
Ambetter Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $416.87 | Professional | None | $177.83 | $302.00 | $416.87 |
BCBS Texas Setting Facility Modifier None Typical Low $4,365.16 Median $7,585.78 Typical High $16,982.44 | Facility | None | $4,365.16 | $7,585.78 | $16,982.44 |
BCBS Texas Setting Professional Modifier None Typical Low $302.00 Median $1,412.54 Typical High $2,511.89 | Professional | None | $302.00 | $1,412.54 | $2,511.89 |
Baylor Scott & White Setting Facility Modifier None Typical Low $5,128.61 Median $7,943.28 Typical High $18,620.87 | Facility | None | $5,128.61 | $7,943.28 | $18,620.87 |
Christus Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Facility | None | $5,128.61 | $5,128.61 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $977.24 Typical High $2,754.23 | Professional | None | $407.38 | $977.24 | $2,754.23 |
Lucent Health Setting Professional Modifier None Typical Low $14,454.40 Median $20,417.38 Typical High $20,417.38 | Professional | None | $14,454.40 | $20,417.38 | $20,417.38 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $3,715.35 Typical High $8,317.64 | Facility | None | $660.69 | $3,715.35 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $1,348.96 Typical High $2,691.53 | Professional | None | $346.74 | $1,348.96 | $2,691.53 |
Molina Setting Professional Modifier None Typical Low $346.74 Median $1,949.84 Typical High $2,570.40 | Professional | None | $346.74 | $1,949.84 | $2,570.40 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $8,709.64 | Professional | None | $1,174.90 | $1,318.26 | $8,709.64 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,388.44 | Facility | None | $346.74 | $954.99 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $1,096.48 Typical High $2,754.23 | Professional | None | $426.58 | $1,096.48 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $8,709.64 Typical High $18,620.87 | Facility | None | $2,630.27 | $8,709.64 | $18,620.87 |
United Setting Professional Modifier None Typical Low $331.13 Median $1,380.38 Typical High $2,691.53 | Professional | None | $331.13 | $1,380.38 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
13 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 $173.78 Median $724.44 Typical High $1,288.25 | Professional | 52 · Reduced service | $173.78 | $724.44 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $288.40 Typical High $512.86 | Professional | 53 · Discontinued | $69.18 | $288.40 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,071.52 Typical High $1,905.46 | Professional | 54 · Surgery only | $263.03 | $1,071.52 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $213.80 Typical High $380.19 | Professional | 55 · Aftercare only | $52.48 | $213.80 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $144.54 Typical High $257.04 | Professional | 56 · Pre-op care only | $34.67 | $144.54 | $257.04 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $645.65 Typical High $758.58 | Professional | 50 · Both sides | $478.63 | $645.65 | $758.58 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $4,365.16 Median $8,709.64 Typical High $11,748.98 | Facility | 50 · Both sides | $4,365.16 | $8,709.64 | $11,748.98 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $467.74 Median $1,071.52 Typical High $2,754.23 | Professional | 50 · Both sides | $467.74 | $1,071.52 | $2,754.23 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $794.33 Typical High $1,258.93 | Professional | 52 · Reduced service | $173.78 | $794.33 | $1,258.93 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $323.59 Typical High $501.19 | Professional | 53 · Discontinued | $69.18 | $323.59 | $501.19 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,202.26 Typical High $1,905.46 | Professional | 54 · Surgery only | $263.03 | $1,202.26 | $1,905.46 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $245.47 Typical High $380.19 | Professional | 55 · Aftercare only | $52.48 | $245.47 | $380.19 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $158.49 Typical High $251.19 | Professional | 56 · Pre-op care only | $34.67 | $158.49 | $251.19 |
Where Texas sits
The same service costs 6.3 times more in Washington 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· 21st of 51
$1,950
WA $3,236MD $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.