How much rates vary
Facilitymedian $1,202 · 10th to 90th $269 to $6,310Professionalmedian $708 · 10th to 90th $170 to $1,349
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 $245.47 Median $831.76 Typical High $1,174.90 | Professional | None | $245.47 | $831.76 | $1,174.90 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $269.15 | Professional | None | $109.65 | $218.78 | $269.15 |
BCBS Texas Setting Facility Modifier None Typical Low $3,548.13 Median $7,413.10 Typical High $7,413.10 | Facility | None | $3,548.13 | $7,413.10 | $7,413.10 |
BCBS Texas Setting Professional Modifier None Typical Low $223.87 Median $562.34 Typical High $1,148.15 | Professional | None | $223.87 | $562.34 | $1,148.15 |
Christus Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $1,258.93 | Professional | None | $288.40 | $524.81 | $1,258.93 |
Lucent Health Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $2,570.40 Typical High $8,317.64 | Facility | None | $616.60 | $2,570.40 | $8,317.64 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $758.58 Typical High $1,174.90 | Professional | None | $245.47 | $758.58 | $1,174.90 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $676.08 Typical High $870.96 | Professional | None | $120.23 | $676.08 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $2,951.21 | Professional | None | $794.33 | $870.96 | $2,951.21 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $758.58 Typical High $1,584.89 | Facility | None | $263.03 | $758.58 | $1,584.89 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $1,230.27 | Professional | None | $288.40 | $524.81 | $1,230.27 |
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 $239.88 Median $630.96 Typical High $1,380.38 | Professional | None | $239.88 | $630.96 | $1,380.38 |
Wellpoint Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
11 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 $123.03 Median $380.19 Typical High $549.54 | Professional | 52 · Reduced service | $123.03 | $380.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $151.36 Typical High $218.78 | Professional | 53 · Discontinued | $48.98 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $562.34 Typical High $831.76 | Professional | 54 · Surgery only | $181.97 | $562.34 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $112.20 Typical High $165.96 | Professional | 55 · Aftercare only | $36.31 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $75.86 Typical High $109.65 | Professional | 56 · Pre-op care only | $24.55 | $75.86 | $109.65 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 51 · Multiple procedures | $218.78 | $218.78 | $218.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $380.19 Typical High $537.03 | Professional | 52 · Reduced service | $123.03 | $380.19 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $154.88 Typical High $213.80 | Professional | 53 · Discontinued | $48.98 | $154.88 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $575.44 Typical High $812.83 | Professional | 54 · Surgery only | $181.97 | $575.44 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $114.82 Typical High $162.18 | Professional | 55 · Aftercare only | $36.31 | $114.82 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $75.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $24.55 | $75.86 | $107.15 |
Where Texas sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 34th of 51
$724
WI $1,380HI $324
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.