How much rates vary
Facilitymedian $1,230 · 10th to 90th $457 to $3,890Professionalmedian $191 · 10th to 90th $41 to $355
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 $77.62 Median $204.17 Typical High $309.03 | Professional | None | $77.62 | $204.17 | $309.03 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
BCBS Texas Setting Facility Modifier None Typical Low $758.58 Median $1,318.26 Typical High $3,090.30 | Facility | None | $758.58 | $1,318.26 | $3,090.30 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $275.42 | Professional | None | $74.13 | $190.55 | $275.42 |
Christus Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,412.54 | Facility | None | $446.68 | $660.69 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $288.40 | Professional | None | $83.18 | $173.78 | $288.40 |
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 $87.10 Median $1,000.00 Typical High $4,570.88 | Facility | None | $87.10 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $199.53 Typical High $309.03 | Professional | None | $77.62 | $199.53 | $309.03 |
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 $169.82 Median $281.84 Typical High $891.25 | Professional | None | $169.82 | $281.84 | $891.25 |
Providence Setting Facility Modifier None Typical Low $234.42 Median $707.95 Typical High $3,801.89 | Facility | None | $234.42 | $707.95 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $83.18 Median $173.78 Typical High $288.40 | Professional | None | $83.18 | $173.78 | $288.40 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,801.89 | Facility | None | $616.60 | $1,995.26 | $3,801.89 |
United Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $245.47 | Professional | None | $66.07 | $141.25 | $245.47 |
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 $38.90 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $38.90 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $42.66 Typical High $51.29 | Professional | 53 · Discontinued | $15.49 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $57.54 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $11.75 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $21.38 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $21.38 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $38.90 | $104.71 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $15.49 | $41.69 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $57.54 | $154.88 | $190.55 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $11.75 | $30.90 | $38.02 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $20.89 | $25.70 |
Where Texas sits
The same service costs 4.1 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· 23rd of 51
$195
AK $398DC $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.