How much rates vary
Facilitymedian $1,995 · 10th to 90th $347 to $6,918Professionalmedian $204 · 10th to 90th $32 to $398
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $316.23 | Professional | None | $229.09 | $245.47 | $316.23 |
BCBS Texas Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $524.81 | Professional | None | $218.78 | $281.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $371.54 | Professional | None | $204.17 | $295.12 | $371.54 |
Lucent Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,365.16 | $4,365.16 | $4,365.16 |
Moda Health Setting Facility Modifier None Typical Low $229.09 Median $1,819.70 Typical High $6,918.31 | Facility | None | $229.09 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $295.12 | Professional | None | $229.09 | $245.47 | $295.12 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $218.78 | Professional | None | $29.51 | $162.18 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $794.33 Typical High $794.33 | Professional | None | $275.42 | $794.33 | $794.33 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $660.69 Typical High $2,691.53 | Facility | None | $229.09 | $660.69 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $295.12 Typical High $363.08 | Professional | None | $204.17 | $295.12 | $363.08 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $371.54 | Professional | None | $190.55 | $251.19 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $114.82 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $114.82 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $45.71 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $186.21 Typical High $218.78 | Professional | 54 · Surgery only | $169.82 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $37.15 Typical High $43.65 | Professional | 55 · Aftercare only | $33.88 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $29.51 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $114.82 | $123.03 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $48.98 | $52.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $186.21 Typical High $199.53 | Professional | 54 · Surgery only | $169.82 | $186.21 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $37.15 Typical High $39.81 | Professional | 55 · Aftercare only | $33.88 | $37.15 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $26.30 |
Where Texas sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 50th of 51
$209
AK $977UT $195
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.