How much rates vary
Facilitymedian $708 · 10th to 90th $200 to $3,548Professionalmedian $112 · 10th to 90th $16 to $195
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 $645.65 Median $2,398.83 Typical High $6,918.31 | Facility | None | $645.65 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $186.21 | Professional | None | $120.23 | $138.04 | $186.21 |
BCBS Texas Setting Facility Modifier None Typical Low $380.19 Median $707.95 Typical High $2,089.30 | Facility | None | $380.19 | $707.95 | $2,089.30 |
BCBS Texas Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $190.55 | Professional | None | $112.20 | $141.25 | $190.55 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $338.84 Typical High $1,412.54 | Facility | None | $245.47 | $338.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $199.53 | Professional | None | $102.33 | $147.91 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $1,698.24 Typical High $5,128.61 | Facility | None | $147.91 | $1,698.24 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $162.18 | Professional | None | $120.23 | $138.04 | $162.18 |
Molina Setting Professional Modifier None Typical Low $14.13 Median $79.43 Typical High $109.65 | Professional | None | $14.13 | $79.43 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Professional | None | $169.82 | $169.82 | $177.83 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $407.38 Typical High $3,801.89 | Facility | None | $223.87 | $407.38 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $194.98 | Professional | None | $102.33 | $147.91 | $194.98 |
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 $100.00 Median $131.83 Typical High $194.98 | Professional | None | $100.00 | $131.83 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $60.26 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $91.20 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $15.85 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $69.18 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $28.18 | $31.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $91.20 | $104.71 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $13.80 | $15.85 |
Where Texas sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 50th of 51
$112
AK $501UT $97.72
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.