How much rates vary
Facilitymedian $3,311 · 10th to 90th $282 to $9,772Professionalmedian $1,259 · 10th to 90th $105 to $9,333
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 $97.72 Median $1,445.44 Typical High $1,862.09 | Professional | None | $97.72 | $1,445.44 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $77.62 | Professional | None | $64.57 | $66.07 | $77.62 |
BCBS Texas Setting Facility Modifier None Typical Low $3,548.13 Median $6,309.57 Typical High $14,125.38 | Facility | None | $3,548.13 | $6,309.57 | $14,125.38 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $1,230.27 Typical High $2,951.21 | Professional | None | $102.33 | $1,230.27 | $2,951.21 |
Christus Setting Facility Modifier None Typical Low $77.62 Median $2,951.21 Typical High $2,951.21 | Facility | None | $77.62 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $3,890.45 | Facility | None | $758.58 | $2,754.23 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $2,344.23 | Professional | None | $100.00 | $208.93 | $2,344.23 |
Lucent Health Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $11,748.98 | Professional | None | $9,332.54 | $9,332.54 | $11,748.98 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $1,230.27 Typical High $4,168.69 | Facility | None | $75.86 | $1,230.27 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $97.72 Median $1,230.27 Typical High $1,862.09 | Professional | None | $97.72 | $1,230.27 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $204.17 Median $831.76 Typical High $1,445.44 | Professional | None | $204.17 | $831.76 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $1,348.96 Typical High $3,388.44 | Facility | None | $77.62 | $1,348.96 | $3,388.44 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $2,398.83 | Professional | None | $100.00 | $213.80 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $11,748.98 | Facility | None | $2,137.96 | $5,248.07 | $11,748.98 |
United Setting Professional Modifier None Typical Low $81.28 Median $954.99 Typical High $2,290.87 | Professional | None | $81.28 | $954.99 | $2,290.87 |
Wellpoint Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $48.98 Median $281.84 Typical High $812.83 | Professional | 52 · Reduced service | $48.98 | $281.84 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $112.20 Typical High $323.59 | Professional | 53 · Discontinued | $19.50 | $112.20 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $426.58 Typical High $1,202.26 | Professional | 54 · Surgery only | $74.13 | $426.58 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $85.11 Typical High $245.47 | Professional | 55 · Aftercare only | $14.79 | $85.11 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $56.23 Typical High $162.18 | Professional | 56 · Pre-op care only | $9.77 | $56.23 | $162.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $223.87 Typical High $812.83 | Professional | 52 · Reduced service | $48.98 | $223.87 | $812.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $89.13 Typical High $323.59 | Professional | 53 · Discontinued | $19.50 | $89.13 | $323.59 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $338.84 Typical High $1,202.26 | Professional | 54 · Surgery only | $74.13 | $338.84 | $1,202.26 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $67.61 Typical High $245.47 | Professional | 55 · Aftercare only | $14.79 | $67.61 | $245.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $147.91 Typical High $173.78 | Professional | 56 · Pre-op care only | $10.72 | $147.91 | $173.78 |
Where Texas sits
The same service costs 19.1 times more in Alaska than in Nebraska. 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· 28th of 51
$1,445
AK $3,388NE $178
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.