How much rates vary
Facilitymedian $1,148 · 10th to 90th $550 to $3,715Professionalmedian $195 · 10th to 90th $41 to $389
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 $107.15 Median $218.78 Typical High $257.04 | Professional | None | $107.15 | $218.78 | $257.04 |
BCBS Texas Setting Facility Modifier None Typical Low $575.44 Median $1,148.15 Typical High $2,754.23 | Facility | None | $575.44 | $1,148.15 | $2,754.23 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $275.42 | Professional | None | $102.33 | $190.55 | $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 $117.49 Median $177.83 Typical High $281.84 | Professional | None | $117.49 | $177.83 | $281.84 |
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 $1,548.82 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,548.82 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $120.23 Median $1,000.00 Typical High $4,786.30 | Facility | None | $120.23 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $251.19 | Professional | None | $107.15 | $213.80 | $251.19 |
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 $147.91 Median $147.91 Typical High $158.49 | Professional | None | $147.91 | $147.91 | $158.49 |
Providence Setting Facility Modifier None Typical Low $229.09 Median $870.96 Typical High $3,801.89 | Facility | None | $229.09 | $870.96 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $281.84 | Professional | None | $117.49 | $173.78 | $281.84 |
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 $93.33 Median $158.49 Typical High $275.42 | Professional | None | $93.33 | $158.49 | $275.42 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $52.48 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $52.48 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $21.38 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $79.43 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $32.36 Typical High $38.02 | Professional | 55 · Aftercare only | $15.85 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.47 | $21.38 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $52.48 | $104.71 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $21.38 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $79.43 | $158.49 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $15.85 | $31.62 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $10.47 | $20.89 | $25.12 |
Where Texas sits
The same service costs 3.8 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· 31st of 51
$200
AK $490DC $129
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.