How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,660 to $10,233Professionalmedian $427 · 10th to 90th $68 to $1,175
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 $954.99 Median $3,311.31 Typical High $9,120.11 | Facility | None | $954.99 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $645.65 | Professional | None | $446.68 | $467.74 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | None | $398.11 | $398.11 | $416.87 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $5,128.61 Typical High $12,589.25 | Facility | None | $2,041.74 | $5,128.61 | $12,589.25 |
BCBS Texas Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $676.08 | Professional | None | $371.54 | $436.52 | $676.08 |
Baylor Scott & White Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $676.08 | Professional | None | $398.11 | $457.09 | $676.08 |
Christus Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,570.88 Typical High $6,760.83 | Facility | None | $1,348.96 | $4,570.88 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $741.31 | Professional | None | $389.05 | $549.54 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,311.31 | $3,388.44 | $3,388.44 |
Moda Health Setting Facility Modifier None Typical Low $660.69 Median $3,235.94 Typical High $10,715.19 | Facility | None | $660.69 | $3,235.94 | $10,715.19 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $645.65 | Professional | None | $446.68 | $467.74 | $645.65 |
Molina Setting Professional Modifier None Typical Low $58.88 Median $323.59 Typical High $436.52 | Professional | None | $58.88 | $323.59 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | None | $524.81 | $524.81 | $537.03 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $5,011.87 Typical High $11,748.98 | Facility | None | $660.69 | $5,011.87 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $724.44 | Professional | None | $371.54 | $549.54 | $724.44 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $741.31 | Professional | None | $363.08 | $489.78 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
13 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 $223.87 Median $234.42 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $54.95 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $194.98 Median $194.98 Typical High $489.78 | Professional | 51 · Multiple procedures | $194.98 | $194.98 | $489.78 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 59 · Distinct service | $363.08 | $363.08 | $416.87 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | GC · Resident with teaching physician | $389.05 | $389.05 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $223.87 | $234.42 | $251.19 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $354.81 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $50.12 |
Where Texas sits
The same service costs 6.1 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $8,625MT $1,416
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.