How much rates vary
Facilitymedian $3,090 · 10th to 90th $977 to $7,586Professionalmedian $1,202 · 10th to 90th $219 to $10,471
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,348.96 Typical High $1,737.80 | Professional | None | $331.13 | $1,348.96 | $1,737.80 |
BCBS Texas Setting Professional Modifier None Typical Low $309.03 Median $794.33 Typical High $2,041.74 | Professional | None | $309.03 | $794.33 | $2,041.74 |
Christus Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,754.23 Typical High $3,981.07 | Facility | None | $758.58 | $2,754.23 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $776.25 Typical High $2,041.74 | Professional | None | $371.54 | $776.25 | $2,041.74 |
Lucent Health Setting Professional Modifier None Typical Low $8,709.64 Median $10,471.29 Typical High $10,471.29 | Professional | None | $8,709.64 | $10,471.29 | $10,471.29 |
Moda Health Setting Facility Modifier None Typical Low $407.38 Median $2,041.74 Typical High $5,623.41 | Facility | None | $407.38 | $2,041.74 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $1,348.96 Typical High $1,698.24 | Professional | None | $331.13 | $1,348.96 | $1,698.24 |
Molina Setting Professional Modifier None Typical Low $177.83 Median $977.24 Typical High $1,318.26 | Professional | None | $177.83 | $977.24 | $1,318.26 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $4,466.84 | Professional | None | $1,122.02 | $1,230.27 | $4,466.84 |
Providence Setting Facility Modifier None Typical Low $524.81 Median $2,630.27 Typical High $3,981.07 | Facility | None | $524.81 | $2,630.27 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $776.25 Typical High $2,041.74 | Professional | None | $371.54 | $776.25 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $309.03 Median $1,023.29 Typical High $2,454.71 | Professional | None | $309.03 | $1,023.29 | $2,454.71 |
Wellpoint Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
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 $162.18 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $162.18 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $66.07 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $245.47 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $48.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $33.11 | $128.82 | $151.36 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $162.18 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $162.18 | $645.65 | $758.58 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $66.07 | $257.04 | $302.00 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $245.47 | $977.24 | $1,148.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $48.98 | $194.98 | $229.09 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $33.11 | $128.82 | $151.36 |
Where Texas sits
The same service costs 5.1 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· 34th of 51
$1,380
AK $3,020NE $589
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.