How much rates vary
Facilitymedian $1,862 · 10th to 90th $251 to $4,467Professionalmedian $1,288 · 10th to 90th $234 to $5,754
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 $691.83 Median $2,238.72 Typical High $6,918.31 | Facility | None | $691.83 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $1,096.48 Typical High $1,659.59 | Professional | None | $234.42 | $1,096.48 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $338.84 | Professional | None | $295.12 | $295.12 | $338.84 |
BCBS Texas Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,949.84 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $234.42 Median $870.96 Typical High $1,737.80 | Professional | None | $234.42 | $870.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $724.44 Typical High $1,778.28 | Professional | None | $281.84 | $724.44 | $1,778.28 |
Lucent Health Setting Professional Modifier None Typical Low $9,120.11 Median $13,489.63 Typical High $13,489.63 | Professional | None | $9,120.11 | $13,489.63 | $13,489.63 |
Moda Health Setting Facility Modifier None Typical Low $398.11 Median $1,905.46 Typical High $5,623.41 | Facility | None | $398.11 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $234.42 Median $1,096.48 Typical High $1,659.59 | Professional | None | $234.42 | $1,096.48 | $1,659.59 |
Molina Setting Professional Modifier None Typical Low $223.87 Median $1,288.25 Typical High $1,659.59 | Professional | None | $223.87 | $1,288.25 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $5,754.40 | Professional | None | $794.33 | $891.25 | $5,754.40 |
Providence Setting Facility Modifier None Typical Low $234.42 Median $954.99 Typical High $2,089.30 | Facility | None | $234.42 | $954.99 | $2,089.30 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $741.31 Typical High $1,778.28 | Professional | None | $288.40 | $741.31 | $1,778.28 |
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 $213.80 Median $933.25 Typical High $1,819.70 | Professional | None | $213.80 | $933.25 | $1,819.70 |
Wellpoint Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $117.49 Median $501.19 Typical High $794.33 | Professional | 52 · Reduced service | $117.49 | $501.19 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $199.53 Typical High $316.23 | Professional | 53 · Discontinued | $46.77 | $199.53 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $758.58 Typical High $1,202.26 | Professional | 54 · Surgery only | $173.78 | $758.58 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $151.36 Typical High $239.88 | Professional | 55 · Aftercare only | $34.67 | $151.36 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $100.00 Typical High $158.49 | Professional | 56 · Pre-op care only | $23.44 | $100.00 | $158.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $549.54 Typical High $794.33 | Professional | 52 · Reduced service | $117.49 | $549.54 | $794.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $218.78 Typical High $316.23 | Professional | 53 · Discontinued | $46.77 | $218.78 | $316.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $812.83 Typical High $1,202.26 | Professional | 54 · Surgery only | $173.78 | $812.83 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $162.18 Typical High $239.88 | Professional | 55 · Aftercare only | $34.67 | $162.18 | $239.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $109.65 Typical High $158.49 | Professional | 56 · Pre-op care only | $23.44 | $109.65 | $158.49 |
Where Texas sits
The same service costs 6.5 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· 18th of 51
$1,288
WA $2,138MD $331
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.