How much rates vary
Facilitymedian $3,631 · 10th to 90th $447 to $8,710Professionalmedian $1,514 · 10th to 90th $295 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 $794.33 Median $2,570.40 Typical High $6,918.31 | Facility | None | $794.33 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,318.26 Typical High $2,041.74 | Professional | None | $309.03 | $1,318.26 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $147.91 Typical High $380.19 | Professional | None | $144.54 | $147.91 | $380.19 |
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 $309.03 Median $1,258.93 Typical High $2,290.87 | Professional | None | $309.03 | $1,258.93 | $2,290.87 |
Christus Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $870.96 Typical High $2,187.76 | Professional | None | $363.08 | $870.96 | $2,187.76 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $15,488.17 Typical High $15,488.17 | Professional | None | $11,220.18 | $15,488.17 | $15,488.17 |
Moda Health Setting Facility Modifier None Typical Low $537.03 Median $2,570.40 Typical High $6,309.57 | Facility | None | $537.03 | $2,570.40 | $6,309.57 |
Moda Health Setting Professional Modifier None Typical Low $309.03 Median $1,202.26 Typical High $2,041.74 | Professional | None | $309.03 | $1,202.26 | $2,041.74 |
Molina Setting Professional Modifier None Typical Low $263.03 Median $1,513.56 Typical High $1,949.84 | Professional | None | $263.03 | $1,513.56 | $1,949.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $6,606.93 | Professional | None | $1,047.13 | $1,174.90 | $6,606.93 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $954.99 Typical High $2,570.40 | Facility | None | $309.03 | $954.99 | $2,570.40 |
Providence Setting Professional Modifier None Typical Low $380.19 Median $870.96 Typical High $2,137.96 | Professional | None | $380.19 | $870.96 | $2,137.96 |
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 $295.12 Median $1,122.02 Typical High $2,187.76 | Professional | None | $295.12 | $1,122.02 | $2,187.76 |
Wellpoint Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $154.88 Median $602.56 Typical High $977.24 | Professional | 52 · Reduced service | $154.88 | $602.56 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $245.47 Typical High $389.05 | Professional | 53 · Discontinued | $61.66 | $245.47 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $229.09 | $912.01 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $181.97 Typical High $288.40 | Professional | 55 · Aftercare only | $46.77 | $181.97 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $120.23 Typical High $194.98 | Professional | 56 · Pre-op care only | $30.90 | $120.23 | $194.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $616.60 Typical High $977.24 | Professional | 52 · Reduced service | $154.88 | $616.60 | $977.24 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $245.47 Typical High $389.05 | Professional | 53 · Discontinued | $61.66 | $245.47 | $389.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $229.09 | $912.01 | $1,445.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $186.21 Typical High $288.40 | Professional | 55 · Aftercare only | $46.77 | $186.21 | $288.40 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $123.03 Typical High $194.98 | Professional | 56 · Pre-op care only | $30.90 | $123.03 | $194.98 |
Where Texas sits
The same service costs 5.6 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· 18th of 51
$1,585
WI $2,570MD $457
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.