How much rates vary
Facilitymedian $525 · 10th to 90th $155 to $3,311Professionalmedian $295 · 10th to 90th $63 to $513
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 $81.28 Median $295.12 Typical High $407.38 | Professional | None | $81.28 | $295.12 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
BCBS Texas Setting Facility Modifier None Typical Low $234.42 Median $426.58 Typical High $1,318.26 | Facility | None | $234.42 | $426.58 | $1,318.26 |
BCBS Texas Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $407.38 | Professional | None | $79.43 | $281.84 | $407.38 |
Christus Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $1,479.11 | Facility | None | $141.25 | $194.98 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $208.93 Typical High $446.68 | Professional | None | $91.20 | $208.93 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,290.87 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $114.82 Median $1,202.26 Typical High $5,128.61 | Facility | None | $114.82 | $1,202.26 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $295.12 Typical High $398.11 | Professional | None | $81.28 | $295.12 | $398.11 |
Molina Setting Professional Modifier None Typical Low $52.48 Median $288.40 Typical High $398.11 | Professional | None | $52.48 | $288.40 | $398.11 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $338.84 Typical High $3,801.89 | Facility | None | $134.90 | $338.84 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $208.93 Typical High $446.68 | Professional | None | $91.20 | $208.93 | $446.68 |
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 $70.79 Median $208.93 Typical High $436.52 | Professional | None | $70.79 | $208.93 | $436.52 |
Wellpoint Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
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 $40.74 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $40.74 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $16.22 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $60.26 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $42.66 Typical High $58.88 | Professional | 55 · Aftercare only | $12.02 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $8.13 | $28.18 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $40.74 | $141.25 | $190.55 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $16.22 | $56.23 | $75.86 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $213.80 Typical High $288.40 | Professional | 54 · Surgery only | $60.26 | $213.80 | $288.40 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $42.66 Typical High $57.54 | Professional | 55 · Aftercare only | $12.02 | $42.66 | $57.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $8.13 | $28.18 | $38.02 |
Where Texas sits
The same service costs 4.8 times more in Wisconsin 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· 26th of 51
$295
WI $479DC $100
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.