How much rates vary
Facilitymedian $2,754 · 10th to 90th $646 to $6,607Professionalmedian $195 · 10th to 90th $39 to $1,514
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 $95.50 Median $208.93 Typical High $245.47 | Professional | None | $95.50 | $208.93 | $245.47 |
BCBS Texas Setting Facility Modifier None Typical Low $2,238.72 Median $4,168.69 Typical High $8,709.64 | Facility | None | $2,238.72 | $4,168.69 | $8,709.64 |
BCBS Texas Setting Professional Modifier None Typical Low $95.50 Median $186.21 Typical High $323.59 | Professional | None | $95.50 | $186.21 | $323.59 |
Christus Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Facility | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,659.59 Typical High $2,344.23 | Facility | None | $457.09 | $1,659.59 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $275.42 | Professional | None | $104.71 | $169.82 | $275.42 |
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 $1,513.56 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,513.56 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $1,000.00 Typical High $4,570.88 | Facility | None | $109.65 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $245.47 | Professional | None | $95.50 | $204.17 | $245.47 |
Molina Setting Professional Modifier None Typical Low $33.88 Median $186.21 Typical High $251.19 | Professional | None | $33.88 | $186.21 | $251.19 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $1,659.59 Typical High $3,801.89 | Facility | None | $229.09 | $1,659.59 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $275.42 | Professional | None | $104.71 | $169.82 | $275.42 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,311.31 | $6,606.93 |
United Setting Professional Modifier None Typical Low $81.28 Median $144.54 Typical High $257.04 | Professional | None | $81.28 | $144.54 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $47.86 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $47.86 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $19.05 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $70.79 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $14.13 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.55 | $20.42 | $24.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $47.86 | $100.00 | $120.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $19.05 | $39.81 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $70.79 | $151.36 | $181.97 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $14.13 | $30.20 | $36.31 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $9.55 | $20.42 | $24.55 |
Where Texas sits
The same service costs 4.0 times more in Alaska 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· 24th of 51
$200
AK $468DC $117
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.