How much rates vary
Facilitymedian $2,630 · 10th to 90th $537 to $7,079Professionalmedian $117 · 10th to 90th $17 to $977
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 $691.83 Median $2,290.87 Typical High $6,918.31 | Facility | None | $691.83 | $2,290.87 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $2,454.71 | Professional | None | $117.49 | $128.82 | $2,454.71 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $467.74 | Professional | None | $107.15 | $144.54 | $467.74 |
Christus Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $2,344.23 Typical High $3,311.31 | Facility | None | $457.09 | $2,344.23 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $213.80 | Professional | None | $117.49 | $144.54 | $213.80 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $131.83 Median $1,778.28 Typical High $5,248.07 | Facility | None | $131.83 | $1,778.28 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $204.17 | Professional | None | $117.49 | $128.82 | $204.17 |
Molina Setting Professional Modifier None Typical Low $15.14 Median $83.18 Typical High $109.65 | Professional | None | $15.14 | $83.18 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $363.08 Median $371.54 Typical High $380.19 | Professional | None | $363.08 | $371.54 | $380.19 |
Providence Setting Facility Modifier None Typical Low $338.84 Median $2,344.23 Typical High $3,890.45 | Facility | None | $338.84 | $2,344.23 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $213.80 | Professional | None | $114.82 | $144.54 | $213.80 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,332.54 | Facility | None | $1,698.24 | $4,570.88 | $9,332.54 |
United Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $199.53 | Professional | None | $95.50 | $131.83 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $58.88 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $58.88 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $23.44 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $107.15 | Professional | 54 · Surgery only | $87.10 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $58.88 | $64.57 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $23.44 | $25.70 | $28.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $97.72 Typical High $109.65 | Professional | 54 · Surgery only | $87.10 | $97.72 | $109.65 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $21.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.75 | $12.88 | $14.45 |
Where Texas sits
The same service costs 12.9 times more in Arkansas 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· 47th of 51
$158
AR $1,585NY $123
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.