How much rates vary
Facilitymedian $1,202 · 10th to 90th $389 to $4,169Professionalmedian $245 · 10th to 90th $49 to $2,239
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $239.88 Typical High $426.58 | Professional | None | $107.15 | $239.88 | $426.58 |
BCBS Texas Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $3,090.30 | Facility | None | $630.96 | $1,202.26 | $3,090.30 |
BCBS Texas Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $309.03 | Professional | None | $104.71 | $204.17 | $309.03 |
Christus Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $831.76 Typical High $1,862.09 | Facility | None | $588.84 | $831.76 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $331.13 | Professional | None | $120.23 | $208.93 | $331.13 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,659.59 | $1,659.59 | $2,238.72 |
Moda Health Setting Facility Modifier None Typical Low $147.91 Median $1,148.15 Typical High $4,786.30 | Facility | None | $147.91 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $239.88 Typical High $331.13 | Professional | None | $107.15 | $239.88 | $331.13 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $213.80 Typical High $288.40 | Professional | None | $38.90 | $213.80 | $288.40 |
Providence Setting Facility Modifier None Typical Low $245.47 Median $891.25 Typical High $4,466.84 | Facility | None | $245.47 | $891.25 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $331.13 | Professional | None | $120.23 | $208.93 | $331.13 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,311.31 | Facility | None | $389.05 | $1,288.25 | $3,311.31 |
United Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $316.23 | Professional | None | $93.33 | $173.78 | $316.23 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $53.70 Median $112.20 Typical High $134.90 | Professional | 52 · Reduced service | $53.70 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $21.38 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $81.28 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $33.88 Typical High $40.74 | Professional | 55 · Aftercare only | $16.22 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $22.39 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.72 | $22.39 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $53.70 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $53.70 | $114.82 | $134.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $21.38 | $45.71 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $169.82 Typical High $199.53 | Professional | 54 · Surgery only | $81.28 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $34.67 Typical High $39.81 | Professional | 55 · Aftercare only | $16.22 | $34.67 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.72 | $22.91 | $26.92 |
Where Texas sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 23rd of 51
$295
AK $776KY $182
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.