How much rates vary
Facilitymedian $170 · 10th to 90th $87 to $2,291Professionalmedian $91 · 10th to 90th $18 to $851
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $97.72 Typical High $125.89 | Professional | None | $27.54 | $97.72 | $125.89 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
BCBS Texas Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $831.76 | Facility | None | $87.10 | $134.90 | $831.76 |
BCBS Texas Setting Professional Modifier None Typical Low $28.84 Median $91.20 Typical High $158.49 | Professional | None | $28.84 | $91.20 | $158.49 |
Christus Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $112.20 Typical High $177.83 | Facility | None | $66.07 | $112.20 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $79.43 Typical High $144.54 | Professional | None | $30.90 | $79.43 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Professional | None | $851.14 | $851.14 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $37.15 Median $1,000.00 Typical High $4,786.30 | Facility | None | $37.15 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $27.54 Median $97.72 Typical High $138.04 | Professional | None | $27.54 | $97.72 | $138.04 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $109.65 Typical High $169.82 | Facility | None | $50.12 | $109.65 | $169.82 |
Providence Setting Professional Modifier None Typical Low $30.90 Median $79.43 Typical High $144.54 | Professional | None | $30.90 | $79.43 | $144.54 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $28.18 Median $74.13 Typical High $147.91 | Professional | None | $28.18 | $74.13 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $13.80 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $13.80 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $18.62 Typical High $21.88 | Professional | 53 · Discontinued | $5.50 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $69.18 Typical High $81.28 | Professional | 54 · Surgery only | $20.89 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $4.17 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.75 | $9.12 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $46.77 Typical High $53.70 | Professional | 52 · Reduced service | $13.80 | $46.77 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $18.62 Typical High $21.88 | Professional | 53 · Discontinued | $5.50 | $18.62 | $21.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $69.18 Typical High $81.28 | Professional | 54 · Surgery only | $20.89 | $69.18 | $81.28 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $4.17 | $13.80 | $16.22 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $9.33 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.75 | $9.33 | $10.72 |
Where Texas sits
The same service costs 5.4 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· 32nd of 51
$100
WI $209HI $38.90
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.