How much rates vary
Facilitymedian $1,905 · 10th to 90th $195 to $6,918Professionalmedian $135 · 10th to 90th $83 to $1,862
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 $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $162.18 | Professional | None | $120.23 | $125.89 | $162.18 |
BCBS Texas Setting Facility Modifier None Typical Low $4,073.80 Median $8,709.64 Typical High $8,709.64 | Facility | None | $4,073.80 | $8,709.64 | $8,709.64 |
BCBS Texas Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $208.93 | Professional | None | $117.49 | $147.91 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $251.19 | Professional | None | $134.90 | $162.18 | $251.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Moda Health Setting Facility Modifier None Typical Low $186.21 Median $1,949.84 Typical High $6,025.60 | Facility | None | $186.21 | $1,949.84 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $162.18 | Professional | None | $120.23 | $125.89 | $162.18 |
Molina Setting Professional Modifier None Typical Low $15.85 Median $95.50 Typical High $112.20 | Professional | None | $15.85 | $95.50 | $112.20 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $269.15 | Facility | None | $123.03 | $181.97 | $269.15 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $245.47 | Professional | None | $134.90 | $162.18 | $245.47 |
United Setting Facility Modifier None Typical Low $177.83 Median $1,348.96 Typical High $2,691.53 | Facility | None | $177.83 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $223.87 | Professional | None | $107.15 | $141.25 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $60.26 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $91.20 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $15.14 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | GC · Resident with teaching physician | $54.95 | $54.95 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $60.26 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $31.62 | Professional | 53 · Discontinued | $23.99 | $25.12 | $31.62 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $93.33 Typical High $120.23 | Professional | 54 · Surgery only | $91.20 | $93.33 | $120.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $23.99 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $15.85 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $15.85 |
Where Texas sits
The same service costs 3.7 times more in Alaska 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· 44th of 51
$138
AK $447NY $120
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.