How much rates vary
Facilitymedian $1,514 · 10th to 90th $646 to $4,074Professionalmedian $380 · 10th to 90th $78 to $2,951
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $416.87 Typical High $489.78 | Professional | None | $154.88 | $416.87 | $489.78 |
BCBS Texas Setting Facility Modifier None Typical Low $724.44 Median $1,513.56 Typical High $4,168.69 | Facility | None | $724.44 | $1,513.56 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $147.91 Median $363.08 Typical High $616.60 | Professional | None | $147.91 | $363.08 | $616.60 |
Christus Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,096.48 Typical High $1,659.59 | Facility | None | $457.09 | $1,096.48 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $537.03 | Professional | None | $165.96 | $323.59 | $537.03 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,073.80 | Professional | None | $2,951.21 | $2,951.21 | $4,073.80 |
Moda Health Setting Facility Modifier None Typical Low $194.98 Median $1,000.00 Typical High $4,570.88 | Facility | None | $194.98 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $489.78 | Professional | None | $154.88 | $407.38 | $489.78 |
Molina Setting Professional Modifier None Typical Low $67.61 Median $371.54 Typical High $501.19 | Professional | None | $67.61 | $371.54 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | None | $218.78 | $218.78 | $229.09 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $1,096.48 Typical High $3,801.89 | Facility | None | $380.19 | $1,096.48 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $537.03 | Professional | None | $165.96 | $323.59 | $537.03 |
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 $134.90 Median $295.12 Typical High $524.81 | Professional | None | $134.90 | $295.12 | $524.81 |
Wellpoint Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $77.62 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $77.62 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $30.90 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $114.82 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $22.91 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $15.49 | $40.74 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $77.62 | $204.17 | $239.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $30.90 | $81.28 | $97.72 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $114.82 | $302.00 | $363.08 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $61.66 Typical High $72.44 | Professional | 55 · Aftercare only | $22.91 | $61.66 | $72.44 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $15.49 | $40.74 | $48.98 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 23rd of 51
$398
AK $851DC $191
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.