How much rates vary
Facilitymedian $2,188 · 10th to 90th $646 to $5,012Professionalmedian $170 · 10th to 90th $33 to $1,445
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 $79.43 Median $199.53 Typical High $234.42 | Professional | None | $79.43 | $199.53 | $234.42 |
BCBS Texas Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $6,025.60 | Facility | None | $1,318.26 | $2,511.89 | $6,025.60 |
BCBS Texas Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $302.00 | Professional | None | $79.43 | $177.83 | $302.00 |
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 $87.10 Median $162.18 Typical High $263.03 | Professional | None | $87.10 | $162.18 | $263.03 |
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 $1,445.44 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,445.44 | $1,995.26 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,000.00 Typical High $4,570.88 | Facility | None | $95.50 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $234.42 | Professional | None | $79.43 | $194.98 | $234.42 |
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 $107.15 Median $107.15 Typical High $112.20 | Professional | None | $107.15 | $107.15 | $112.20 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $1,659.59 Typical High $3,801.89 | Facility | None | $218.78 | $1,659.59 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $263.03 | Professional | None | $87.10 | $162.18 | $263.03 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,890.45 | Facility | None | $616.60 | $2,041.74 | $3,890.45 |
United Setting Professional Modifier None Typical Low $70.79 Median $138.04 Typical High $245.47 | Professional | None | $70.79 | $138.04 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $39.81 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $39.81 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $15.85 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $147.91 Typical High $177.83 | Professional | 54 · Surgery only | $60.26 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $29.51 Typical High $35.48 | Professional | 55 · Aftercare only | $12.02 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.94 | $19.50 | $23.44 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $39.81 | $95.50 | $117.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $15.85 | $38.90 | $46.77 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $60.26 | $144.54 | $173.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $12.02 | $28.84 | $34.67 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $19.50 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.94 | $19.50 | $23.44 |
Where Texas sits
The same service costs 4.5 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· 33rd of 51
$174
AK $437DC $97.72
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.