How much rates vary
Facilitymedian $1,047 · 10th to 90th $437 to $3,548Professionalmedian $589 · 10th to 90th $132 to $1,202
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 $660.69 Median $2,238.72 Typical High $6,918.31 | Facility | None | $660.69 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $549.54 Typical High $954.99 | Professional | None | $165.96 | $549.54 | $954.99 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $660.69 | Professional | None | $134.90 | $144.54 | $660.69 |
BCBS Texas Setting Facility Modifier None Typical Low $371.54 Median $707.95 Typical High $3,090.30 | Facility | None | $371.54 | $707.95 | $3,090.30 |
BCBS Texas Setting Professional Modifier None Typical Low $134.90 Median $478.63 Typical High $851.14 | Professional | None | $134.90 | $478.63 | $851.14 |
Christus Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $741.31 Typical High $1,148.15 | Facility | None | $537.03 | $741.31 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $389.05 Typical High $912.01 | Professional | None | $177.83 | $389.05 | $912.01 |
Lucent Health Setting Professional Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,786.30 | $5,888.44 | $5,888.44 |
Moda Health Setting Facility Modifier None Typical Low $288.40 Median $1,584.89 Typical High $5,495.41 | Facility | None | $288.40 | $1,584.89 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $165.96 Median $524.81 Typical High $954.99 | Professional | None | $165.96 | $524.81 | $954.99 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $588.84 Typical High $758.58 | Professional | None | $104.71 | $588.84 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $575.44 Typical High $2,511.89 | Professional | None | $144.54 | $575.44 | $2,511.89 |
Providence Setting Facility Modifier None Typical Low $281.84 Median $741.31 Typical High $1,148.15 | Facility | None | $281.84 | $741.31 | $1,148.15 |
Providence Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $933.25 | Professional | None | $177.83 | $416.87 | $933.25 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $141.25 Median $446.68 Typical High $870.96 | Professional | None | $141.25 | $446.68 | $870.96 |
Wellpoint Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
11 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 $83.18 Median $245.47 Typical High $436.52 | Professional | 52 · Reduced service | $83.18 | $245.47 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $97.72 Typical High $173.78 | Professional | 53 · Discontinued | $33.11 | $97.72 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $363.08 Typical High $660.69 | Professional | 54 · Surgery only | $123.03 | $363.08 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $72.44 Typical High $131.83 | Professional | 55 · Aftercare only | $25.12 | $72.44 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $48.98 Typical High $87.10 | Professional | 56 · Pre-op care only | $16.60 | $48.98 | $87.10 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 79 · Unrelated procedure after surgery | $660.69 | $660.69 | $660.69 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $275.42 Typical High $436.52 | Professional | 52 · Reduced service | $83.18 | $275.42 | $436.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $109.65 Typical High $173.78 | Professional | 53 · Discontinued | $33.11 | $109.65 | $173.78 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $407.38 Typical High $660.69 | Professional | 54 · Surgery only | $123.03 | $407.38 | $660.69 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $81.28 Typical High $131.83 | Professional | 55 · Aftercare only | $25.12 | $81.28 | $131.83 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $60.26 Typical High $87.10 | Professional | 56 · Pre-op care only | $16.60 | $60.26 | $87.10 |
Where Texas sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 29th of 51
$617
WI $1,148HI $219
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.