How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,288 to $11,220Professionalmedian $741 · 10th to 90th $151 to $5,888
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 $851.14 Median $2,570.40 Typical High $6,918.31 | Facility | None | $851.14 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $741.31 Typical High $977.24 | Professional | None | $199.53 | $741.31 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
BCBS Texas Setting Facility Modifier None Typical Low $2,951.21 Median $5,495.41 Typical High $11,220.18 | Facility | None | $2,951.21 | $5,495.41 | $11,220.18 |
BCBS Texas Setting Professional Modifier None Typical Low $194.98 Median $676.08 Typical High $1,230.27 | Professional | None | $194.98 | $676.08 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $537.03 Typical High $1,148.15 | Professional | None | $218.78 | $537.03 | $1,148.15 |
Lucent Health Setting Professional Modifier None Typical Low $5,888.44 Median $7,079.46 Typical High $7,079.46 | Professional | None | $5,888.44 | $7,079.46 | $7,079.46 |
Moda Health Setting Facility Modifier None Typical Low $446.68 Median $1,995.26 Typical High $5,623.41 | Facility | None | $446.68 | $1,995.26 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $199.53 Median $741.31 Typical High $977.24 | Professional | None | $199.53 | $741.31 | $977.24 |
Molina Setting Professional Modifier None Typical Low $120.23 Median $676.08 Typical High $870.96 | Professional | None | $120.23 | $676.08 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $10,715.19 Typical High $15,488.17 | Facility | None | $302.00 | $10,715.19 | $15,488.17 |
Providence Setting Professional Modifier None Typical Low $218.78 Median $549.54 Typical High $1,148.15 | Professional | None | $218.78 | $549.54 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $5,754.40 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,754.40 | $11,220.18 |
United Setting Professional Modifier None Typical Low $194.98 Median $616.60 Typical High $1,148.15 | Professional | None | $194.98 | $616.60 | $1,148.15 |
Wellpoint Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $100.00 Median $346.74 Typical High $489.78 | Professional | 52 · Reduced service | $100.00 | $346.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $138.04 Typical High $194.98 | Professional | 53 · Discontinued | $40.74 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $512.86 Typical High $724.44 | Professional | 54 · Surgery only | $151.36 | $512.86 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $104.71 Typical High $144.54 | Professional | 55 · Aftercare only | $30.20 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $70.79 Typical High $97.72 | Professional | 56 · Pre-op care only | $19.95 | $70.79 | $97.72 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 59 · Distinct service | $177.83 | $177.83 | $177.83 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $100.00 Median $363.08 Typical High $489.78 | Professional | 52 · Reduced service | $100.00 | $363.08 | $489.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $147.91 Typical High $194.98 | Professional | 53 · Discontinued | $40.74 | $147.91 | $194.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $549.54 Typical High $724.44 | Professional | 54 · Surgery only | $151.36 | $549.54 | $724.44 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $30.20 | $109.65 | $144.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $74.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $19.95 | $74.13 | $97.72 |
Where Texas sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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· 29th of 51
$776
WI $1,514MD $282
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.