How much rates vary
Facilitymedian $1,995 · 10th to 90th $162 to $4,786Professionalmedian $95 · 10th to 90th $38 to $200
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 $676.08 Median $2,570.40 Typical High $6,918.31 | Facility | None | $676.08 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $123.03 Typical High $169.82 | Professional | None | $47.86 | $123.03 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $120.23 | Professional | None | $38.02 | $79.43 | $120.23 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $4,265.80 Typical High $4,365.16 | Facility | None | $2,041.74 | $4,265.80 | $4,365.16 |
BCBS Texas Setting Professional Modifier None Typical Low $44.67 Median $91.20 Typical High $169.82 | Professional | None | $44.67 | $91.20 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $194.98 | Professional | None | $53.70 | $97.72 | $194.98 |
Lucent Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $117.49 Median $2,041.74 Typical High $6,918.31 | Facility | None | $117.49 | $2,041.74 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $47.86 Median $123.03 Typical High $169.82 | Professional | None | $47.86 | $123.03 | $169.82 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $87.10 Typical High $107.15 | Professional | None | $14.79 | $87.10 | $107.15 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $158.49 Typical High $416.87 | Professional | None | $151.36 | $158.49 | $416.87 |
Providence Setting Facility Modifier None Typical Low $48.98 Median $107.15 Typical High $218.78 | Facility | None | $48.98 | $107.15 | $218.78 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $190.55 | Professional | None | $53.70 | $97.72 | $190.55 |
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 $44.67 Median $107.15 Typical High $213.80 | Professional | None | $44.67 | $107.15 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $23.99 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $23.99 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $22.91 Typical High $30.90 | Professional | 53 · Discontinued | $9.55 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $35.48 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $7.24 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.79 | $11.48 | $15.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $23.99 | $57.54 | $77.62 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $23.44 Typical High $30.90 | Professional | 53 · Discontinued | $9.55 | $23.44 | $30.90 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $35.48 | $87.10 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $7.24 | $17.38 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $11.75 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.79 | $11.75 | $15.49 |
Where Texas sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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· 46th of 51
$97.72
WI $234FL $85.11
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.