How much rates vary
Facilitymedian $955 · 10th to 90th $479 to $3,802Professionalmedian $813 · 10th to 90th $89 to $3,467
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 $691.83 Median $2,238.72 Typical High $6,918.31 | Facility | None | $691.83 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $794.33 Typical High $1,288.25 | Professional | None | $81.28 | $794.33 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
BCBS Texas Setting Facility Modifier None Typical Low $478.63 Median $741.31 Typical High $3,311.31 | Facility | None | $478.63 | $741.31 | $3,311.31 |
BCBS Texas Setting Professional Modifier None Typical Low $77.62 Median $316.23 Typical High $1,380.38 | Professional | None | $77.62 | $316.23 | $1,380.38 |
Christus Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,584.89 | Facility | None | $489.78 | $831.76 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $331.13 Typical High $1,258.93 | Professional | None | $89.13 | $331.13 | $1,258.93 |
Lucent Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $8,912.51 | Professional | None | $6,456.54 | $6,456.54 | $8,912.51 |
Moda Health Setting Facility Modifier None Typical Low $93.33 Median $1,202.26 Typical High $4,677.35 | Facility | None | $93.33 | $1,202.26 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $776.25 Typical High $1,288.25 | Professional | None | $81.28 | $776.25 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $141.25 Median $794.33 Typical High $1,071.52 | Professional | None | $141.25 | $794.33 | $1,071.52 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $83.18 | Professional | None | $77.62 | $77.62 | $83.18 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $3,801.89 | Facility | None | $354.81 | $912.01 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $338.84 Typical High $1,258.93 | Professional | None | $89.13 | $338.84 | $1,258.93 |
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 $70.79 Median $562.34 Typical High $1,148.15 | Professional | None | $70.79 | $562.34 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
11 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 $316.23 Typical High $549.54 | Professional | 52 · Reduced service | $40.74 | $316.23 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $125.89 Typical High $223.87 | Professional | 53 · Discontinued | $16.22 | $125.89 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $478.63 Typical High $831.76 | Professional | 54 · Surgery only | $60.26 | $478.63 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $95.50 Typical High $165.96 | Professional | 55 · Aftercare only | $12.30 | $95.50 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $70.79 Typical High $109.65 | Professional | 56 · Pre-op care only | $8.13 | $70.79 | $109.65 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 51 · Multiple procedures | $77.62 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $162.18 Typical High $537.03 | Professional | 52 · Reduced service | $40.74 | $162.18 | $537.03 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $125.89 Typical High $213.80 | Professional | 53 · Discontinued | $16.22 | $125.89 | $213.80 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $478.63 Typical High $812.83 | Professional | 54 · Surgery only | $60.26 | $478.63 | $812.83 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $107.15 Typical High $162.18 | Professional | 55 · Aftercare only | $12.30 | $107.15 | $162.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $102.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $102.33 | $114.82 |
Where Texas sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 20th of 51
$813
WA $1,288KY $91.20
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.