How much rates vary
Facilitymedian $1,148 · 10th to 90th $537 to $3,715Professionalmedian $166 · 10th to 90th $34 to $1,259
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 $575.44 Median $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $181.97 Typical High $208.93 | Professional | None | $69.18 | $181.97 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $194.98 Typical High $194.98 | Professional | None | $83.18 | $194.98 | $194.98 |
BCBS Texas Setting Facility Modifier None Typical Low $575.44 Median $1,174.90 Typical High $2,818.38 | Facility | None | $575.44 | $1,174.90 | $2,818.38 |
BCBS Texas Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $275.42 | Professional | None | $67.61 | $158.49 | $275.42 |
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 $457.09 Median $812.83 Typical High $1,584.89 | Facility | None | $457.09 | $812.83 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $234.42 | Professional | None | $75.86 | $141.25 | $234.42 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,258.93 | $1,737.80 |
Moda Health Setting Facility Modifier None Typical Low $74.13 Median $1,000.00 Typical High $4,677.35 | Facility | None | $74.13 | $1,000.00 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $173.78 Typical High $213.80 | Professional | None | $69.18 | $173.78 | $213.80 |
Molina Setting Professional Modifier None Typical Low $28.84 Median $158.49 Typical High $213.80 | Professional | None | $28.84 | $158.49 | $213.80 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | None | $85.11 | $85.11 | $89.13 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $870.96 Typical High $3,801.89 | Facility | None | $190.55 | $870.96 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $234.42 | Professional | None | $75.86 | $141.25 | $234.42 |
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 $61.66 Median $125.89 Typical High $223.87 | Professional | None | $61.66 | $125.89 | $223.87 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $34.67 Median $87.10 Typical High $104.71 | Professional | 52 · Reduced service | $34.67 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $34.67 Typical High $41.69 | Professional | 53 · Discontinued | $13.80 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $128.82 Typical High $154.88 | Professional | 54 · Surgery only | $52.48 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $10.47 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $17.38 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.92 | $17.38 | $20.89 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $34.67 | $87.10 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $34.67 Typical High $40.74 | Professional | 53 · Discontinued | $13.80 | $34.67 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $128.82 Typical High $154.88 | Professional | 54 · Surgery only | $52.48 | $128.82 | $154.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $25.70 Typical High $30.90 | Professional | 55 · Aftercare only | $10.47 | $25.70 | $30.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.92 | $17.38 | $20.42 |
Where Texas sits
The same service costs 11.4 times more in Colorado than in North Dakota. 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
CO $3,976ND $348
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.