How much rates vary
Facilitymedian $3,981 · 10th to 90th $813 to $11,749Professionalmedian $1,514 · 10th to 90th $148 to $11,482
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 $2,238.72 Typical High $6,918.31 | Facility | None | $691.83 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $1,819.70 Typical High $2,290.87 | Professional | None | $144.54 | $1,819.70 | $2,290.87 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
BCBS Texas Setting Facility Modifier None Typical Low $2,951.21 Median $7,079.46 Typical High $14,791.08 | Facility | None | $2,951.21 | $7,079.46 | $14,791.08 |
BCBS Texas Setting Professional Modifier None Typical Low $138.04 Median $1,148.15 Typical High $2,454.71 | Professional | None | $138.04 | $1,148.15 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,584.89 Typical High $2,691.53 | Facility | None | $537.03 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $2,398.83 | Professional | None | $162.18 | $354.81 | $2,398.83 |
Lucent Health Setting Professional Modifier None Typical Low $11,481.54 Median $14,454.40 Typical High $14,454.40 | Professional | None | $11,481.54 | $14,454.40 | $14,454.40 |
Moda Health Setting Facility Modifier None Typical Low $208.93 Median $1,905.46 Typical High $5,248.07 | Facility | None | $208.93 | $1,905.46 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $144.54 Median $1,737.80 Typical High $2,290.87 | Professional | None | $144.54 | $1,737.80 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,348.96 Typical High $1,819.70 | Professional | None | $239.88 | $1,348.96 | $1,819.70 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $512.86 Typical High $6,025.60 | Professional | None | $128.82 | $512.86 | $6,025.60 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $1,584.89 Typical High $2,691.53 | Facility | None | $144.54 | $1,584.89 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $158.49 Median $354.81 Typical High $2,398.83 | Professional | None | $158.49 | $354.81 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $18,620.87 | Facility | None | $2,630.27 | $6,165.95 | $18,620.87 |
United Setting Professional Modifier None Typical Low $134.90 Median $1,071.52 Typical High $2,754.23 | Professional | None | $134.90 | $1,071.52 | $2,754.23 |
Wellpoint Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $72.44 Median $346.74 Typical High $1,023.29 | Professional | 52 · Reduced service | $72.44 | $346.74 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $138.04 Typical High $407.38 | Professional | 53 · Discontinued | $28.84 | $138.04 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $524.81 Typical High $1,548.82 | Professional | 54 · Surgery only | $109.65 | $524.81 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $104.71 Typical High $309.03 | Professional | 55 · Aftercare only | $21.88 | $104.71 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $69.18 Typical High $204.17 | Professional | 56 · Pre-op care only | $14.45 | $69.18 | $204.17 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $346.74 Typical High $1,023.29 | Professional | 52 · Reduced service | $72.44 | $346.74 | $1,023.29 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $138.04 Typical High $407.38 | Professional | 53 · Discontinued | $28.84 | $138.04 | $407.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $524.81 Typical High $1,548.82 | Professional | 54 · Surgery only | $109.65 | $524.81 | $1,548.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $104.71 Typical High $309.03 | Professional | 55 · Aftercare only | $21.88 | $104.71 | $309.03 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $69.18 Typical High $204.17 | Professional | 56 · Pre-op care only | $14.45 | $69.18 | $204.17 |
Where Texas sits
The same service costs 11.2 times more in Oklahoma 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· 33rd of 51
$1,660
OK $2,818HI $251
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.