How much rates vary
Facilitymedian $741 · 10th to 90th $112 to $3,388Professionalmedian $50 · 10th to 90th $30 to $955
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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $2,454.71 | Professional | None | $39.81 | $44.67 | $2,454.71 |
Ambetter Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $39.81 | Professional | None | $27.54 | $27.54 | $39.81 |
BCBS Texas Setting Facility Modifier None Typical Low $323.59 Median $660.69 Typical High $1,819.70 | Facility | None | $323.59 | $660.69 | $1,819.70 |
BCBS Texas Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $138.04 | Professional | None | $35.48 | $45.71 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $67.61 | Professional | None | $39.81 | $47.86 | $67.61 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $954.99 | Professional | None | $616.60 | $954.99 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $44.67 Median $1,737.80 Typical High $5,495.41 | Facility | None | $44.67 | $1,737.80 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $58.88 | Professional | None | $39.81 | $44.67 | $58.88 |
Molina Setting Professional Modifier None Typical Low $5.25 Median $28.84 Typical High $37.15 | Professional | None | $5.25 | $28.84 | $37.15 |
Oscar Health Setting Professional Modifier None Typical Low $35.48 Median $63.10 Typical High $79.43 | Professional | None | $35.48 | $63.10 | $79.43 |
Providence Setting Facility Modifier None Typical Low $34.67 Median $66.07 Typical High $436.52 | Facility | None | $34.67 | $66.07 | $436.52 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $67.61 | Professional | None | $39.81 | $47.86 | $67.61 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $31.62 Median $43.65 Typical High $67.61 | Professional | None | $31.62 | $43.65 | $67.61 |
Wellpoint Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
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 $19.95 Median $22.39 Typical High $24.55 | Professional | 52 · Reduced service | $19.95 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.91 Typical High $9.77 | Professional | 53 · Discontinued | $7.94 | $8.91 | $9.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $33.11 Typical High $37.15 | Professional | 54 · Surgery only | $30.20 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $7.41 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.47 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.98 | $4.47 | $4.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $22.39 Typical High $24.55 | Professional | 52 · Reduced service | $19.95 | $22.39 | $24.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $8.91 Typical High $9.77 | Professional | 53 · Discontinued | $7.94 | $8.91 | $9.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $33.11 Typical High $37.15 | Professional | 54 · Surgery only | $30.20 | $33.11 | $37.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.61 Typical High $7.41 | Professional | 55 · Aftercare only | $6.03 | $6.61 | $7.41 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.47 Typical High $4.90 | Professional | 56 · Pre-op care only | $3.98 | $4.47 | $4.90 |
Where Texas sits
The same service costs 9.3 times more in Tennessee than in New York. 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· 2nd of 51
$347
TN $398NY $42.66
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.