How much rates vary
Facilitymedian $200 · 10th to 90th $100 to $2,455Professionalmedian $105 · 10th to 90th $25 to $178
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 $39.81 Median $85.11 Typical High $154.88 | Professional | None | $39.81 | $85.11 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | None | $100.00 | $123.03 | $123.03 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $1,318.26 | Facility | None | $95.50 | $190.55 | $1,318.26 |
BCBS Texas Setting Professional Modifier None Typical Low $38.02 Median $100.00 Typical High $144.54 | Professional | None | $38.02 | $100.00 | $144.54 |
Baylor Scott & White Setting Professional Modifier None Typical Low $38.90 Median $109.65 Typical High $165.96 | Professional | None | $38.90 | $109.65 | $165.96 |
Christus Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
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 $43.65 Median $89.13 Typical High $144.54 | Professional | None | $43.65 | $89.13 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | None | $812.83 | $812.83 | $1,122.02 |
Moda Health Setting Facility Modifier None Typical Low $41.69 Median $870.96 Typical High $4,570.88 | Facility | None | $41.69 | $870.96 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $39.81 Median $85.11 Typical High $162.18 | Professional | None | $39.81 | $85.11 | $162.18 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $104.71 Typical High $144.54 | Professional | None | $19.50 | $104.71 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $56.23 Median $151.36 Typical High $478.63 | Professional | None | $56.23 | $151.36 | $478.63 |
Providence Setting Facility Modifier None Typical Low $40.74 Median $66.07 Typical High $199.53 | Facility | None | $40.74 | $66.07 | $199.53 |
Providence Setting Professional Modifier None Typical Low $43.65 Median $89.13 Typical High $147.91 | Professional | None | $43.65 | $89.13 | $147.91 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $33.88 Median $69.18 Typical High $123.03 | Professional | None | $33.88 | $69.18 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
13 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 $50.12 Typical High $67.61 | Professional | 52 · Reduced service | $19.50 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $20.42 Typical High $27.54 | Professional | 53 · Discontinued | $7.94 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $75.86 Typical High $102.33 | Professional | 54 · Surgery only | $29.51 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $5.89 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $10.23 Typical High $13.49 | Professional | 56 · Pre-op care only | $3.98 | $10.23 | $13.49 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 58 · Staged procedure | $112.20 | $112.20 | $112.20 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | 59 · Distinct service | $85.11 | $85.11 | $85.11 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | GC · Resident with teaching physician | $19.50 | $19.50 | $19.50 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $52.48 Typical High $66.07 | Professional | 52 · Reduced service | $19.50 | $52.48 | $66.07 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $21.38 Typical High $26.30 | Professional | 53 · Discontinued | $7.94 | $21.38 | $26.30 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $79.43 Typical High $100.00 | Professional | 54 · Surgery only | $29.51 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $15.85 Typical High $19.95 | Professional | 55 · Aftercare only | $5.89 | $15.85 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $3.98 | $10.96 | $13.18 |
Where Texas sits
The same service costs 3.4 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· 18th of 51
$105
AK $178DC $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.