How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,259 to $10,233Professionalmedian $363 · 10th to 90th $58 to $692
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 $1,000.00 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,801.89 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $588.84 | Professional | None | $389.05 | $416.87 | $588.84 |
BCBS Texas Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $707.95 | Professional | None | $371.54 | $467.74 | $707.95 |
Christus Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $5,623.41 Typical High $7,413.10 | Facility | None | $1,737.80 | $5,623.41 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $645.65 | Professional | None | $338.84 | $489.78 | $645.65 |
Health Smart Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Moda Health Setting Facility Modifier None Typical Low $426.58 Median $2,511.89 Typical High $7,079.46 | Facility | None | $426.58 | $2,511.89 | $7,079.46 |
Moda Health Setting Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $512.86 | Professional | None | $389.05 | $416.87 | $512.86 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $302.00 Typical High $398.11 | Professional | None | $53.70 | $302.00 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $457.09 | Professional | None | $436.52 | $436.52 | $457.09 |
Providence Setting Facility Modifier None Typical Low $707.95 Median $6,025.60 Typical High $11,748.98 | Facility | None | $707.95 | $6,025.60 | $11,748.98 |
Providence Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $645.65 | Professional | None | $331.13 | $489.78 | $645.65 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,000.00 | Facility | None | $1,698.24 | $4,570.88 | $10,000.00 |
United Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $616.60 | Professional | None | $323.59 | $436.52 | $616.60 |
Wellpoint Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $194.98 Median $208.93 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $97.72 | Professional | 53 · Discontinued | $77.62 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $295.12 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $48.98 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $208.93 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $208.93 | $223.87 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $83.18 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $83.18 | $89.13 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $309.03 Typical High $338.84 | Professional | 54 · Surgery only | $295.12 | $309.03 | $338.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $67.61 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $67.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $41.69 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $41.69 | $44.67 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 51st of 51
$363
AK $1,622TX $363
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.