How much rates vary
Facilitymedian $1,259 · 10th to 90th $162 to $3,890Professionalmedian $138 · 10th to 90th $28 to $1,122
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $138.04 Typical High $181.97 | Professional | None | $38.90 | $138.04 | $181.97 |
BCBS Texas Setting Facility Modifier None Typical Low $660.69 Median $1,288.25 Typical High $3,801.89 | Facility | None | $660.69 | $1,288.25 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $102.33 Typical High $208.93 | Professional | None | $42.66 | $102.33 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,122.02 | $1,479.11 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $1,000.00 Typical High $4,786.30 | Facility | None | $40.74 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $138.04 Typical High $181.97 | Professional | None | $38.90 | $138.04 | $181.97 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $131.83 Typical High $177.83 | Professional | None | $23.99 | $131.83 | $177.83 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Professional | None | $57.54 | $57.54 | $61.66 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $66.07 Typical High $309.03 | Facility | None | $38.90 | $66.07 | $309.03 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $104.71 Typical High $208.93 | Professional | None | $42.66 | $104.71 | $208.93 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,235.94 | Facility | None | $389.05 | $1,288.25 | $3,235.94 |
United Setting Professional Modifier None Typical Low $33.11 Median $95.50 Typical High $186.21 | Professional | None | $33.11 | $95.50 | $186.21 |
Wellpoint Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $19.50 Median $58.88 Typical High $91.20 | Professional | 52 · Reduced service | $19.50 | $58.88 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $23.44 Typical High $36.31 | Professional | 53 · Discontinued | $7.76 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $87.10 Typical High $138.04 | Professional | 54 · Surgery only | $28.84 | $87.10 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $17.78 Typical High $27.54 | Professional | 55 · Aftercare only | $5.89 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $11.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $3.89 | $11.75 | $18.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $58.88 Typical High $89.13 | Professional | 52 · Reduced service | $19.50 | $58.88 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $23.44 Typical High $35.48 | Professional | 53 · Discontinued | $7.76 | $23.44 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $89.13 Typical High $134.90 | Professional | 54 · Surgery only | $28.84 | $89.13 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $5.89 | $17.78 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $11.75 Typical High $17.78 | Professional | 56 · Pre-op care only | $3.89 | $11.75 | $17.78 |
Where Texas sits
The same service costs 4.6 times more in Wisconsin 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· 21st of 51
$141
WI $240DC $52.48
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.