How much rates vary
Facilitymedian $2,138 · 10th to 90th $407 to $4,571Professionalmedian $182 · 10th to 90th $68 to $676
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $436.52 | Professional | None | $85.11 | $199.53 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $5,128.61 | Facility | None | $1,258.93 | $2,884.03 | $5,128.61 |
BCBS Texas Setting Professional Modifier None Typical Low $75.86 Median $165.96 Typical High $295.12 | Professional | None | $75.86 | $165.96 | $295.12 |
Christus Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,995.26 Typical High $2,884.03 | Facility | None | $489.78 | $1,995.26 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $302.00 | Professional | None | $87.10 | $190.55 | $302.00 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $1,000.00 Typical High $4,786.30 | Facility | None | $123.03 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $288.40 | Professional | None | $85.11 | $199.53 | $288.40 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $218.78 | Professional | None | $29.51 | $162.18 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $199.53 Typical High $457.09 | Professional | None | $85.11 | $199.53 | $457.09 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $1,949.84 Typical High $3,801.89 | Facility | None | $218.78 | $1,949.84 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $186.21 Typical High $288.40 | Professional | None | $87.10 | $186.21 | $288.40 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,388.44 | Facility | None | $389.05 | $1,288.25 | $3,388.44 |
United Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $354.81 | Professional | None | $87.10 | $169.82 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $42.66 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $42.66 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $16.98 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $141.25 Typical High $165.96 | Professional | 54 · Surgery only | $63.10 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $12.88 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.51 | $19.05 | $22.39 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $42.66 | $95.50 | $112.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $16.98 | $38.02 | $44.67 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $144.54 Typical High $165.96 | Professional | 54 · Surgery only | $63.10 | $144.54 | $165.96 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $12.88 | $28.84 | $33.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $8.51 | $19.05 | $22.39 |
Where Texas sits
The same service costs 4.1 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· 45th of 51
$219
AK $646NE $158
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.