How much rates vary
Facilitymedian $5,370 · 10th to 90th $2,344 to $14,454Professionalmedian $1,862 · 10th to 90th $339 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 $2,630.27 | Professional | None | $346.74 | $1,584.89 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $251.19 | Professional | None | $147.91 | $147.91 | $251.19 |
BCBS Texas Setting Facility Modifier None Typical Low $4,466.84 Median $7,762.47 Typical High $15,848.93 | Facility | None | $4,466.84 | $7,762.47 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $295.12 Median $1,412.54 Typical High $2,454.71 | Professional | None | $295.12 | $1,412.54 | $2,454.71 |
Christus Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Facility | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $977.24 Typical High $2,630.27 | Professional | None | $407.38 | $977.24 | $2,630.27 |
Lucent Health Setting Professional Modifier None Typical Low $13,803.84 Median $19,952.62 Typical High $19,952.62 | Professional | None | $13,803.84 | $19,952.62 | $19,952.62 |
Moda Health Setting Facility Modifier None Typical Low $707.95 Median $3,890.45 Typical High $8,912.51 | Facility | None | $707.95 | $3,890.45 | $8,912.51 |
Moda Health Setting Professional Modifier None Typical Low $346.74 Median $1,584.89 Typical High $2,630.27 | Professional | None | $346.74 | $1,584.89 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $331.13 Median $1,905.46 Typical High $2,454.71 | Professional | None | $331.13 | $1,905.46 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $8,511.38 | Professional | None | $1,174.90 | $1,318.26 | $8,511.38 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $954.99 Typical High $3,235.94 | Facility | None | $346.74 | $954.99 | $3,235.94 |
Providence Setting Professional Modifier None Typical Low $426.58 Median $1,096.48 Typical High $2,630.27 | Professional | None | $426.58 | $1,096.48 | $2,630.27 |
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 $323.59 Median $1,412.54 Typical High $2,630.27 | Professional | None | $323.59 | $1,412.54 | $2,630.27 |
Wellpoint Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
12 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 $1,230.27 | Professional | 52 · Reduced service | $173.78 | $724.44 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $295.12 Typical High $489.78 | Professional | 53 · Discontinued | $69.18 | $295.12 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,096.48 Typical High $1,862.09 | Professional | 54 · Surgery only | $263.03 | $1,096.48 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $218.78 Typical High $371.54 | Professional | 55 · Aftercare only | $52.48 | $218.78 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $147.91 Typical High $245.47 | Professional | 56 · Pre-op care only | $34.67 | $147.91 | $245.47 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $478.63 Typical High $630.96 | Professional | 50 · Both sides | $239.88 | $478.63 | $630.96 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $3,235.94 Median $9,120.11 Typical High $13,803.84 | Facility | 50 · Both sides | $3,235.94 | $9,120.11 | $13,803.84 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $776.25 Typical High $1,230.27 | Professional | 52 · Reduced service | $173.78 | $776.25 | $1,230.27 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $316.23 Typical High $489.78 | Professional | 53 · Discontinued | $69.18 | $316.23 | $489.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $1,148.15 Typical High $1,862.09 | Professional | 54 · Surgery only | $263.03 | $1,148.15 | $1,862.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $229.09 Typical High $371.54 | Professional | 55 · Aftercare only | $52.48 | $229.09 | $371.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $158.49 Typical High $245.47 | Professional | 56 · Pre-op care only | $34.67 | $158.49 | $245.47 |
Where Texas sits
The same service costs 6.2 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· 20th of 51
$1,905
WA $3,162MD $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.