How much rates vary
Facilitymedian $1,820 · 10th to 90th $151 to $4,467Professionalmedian $100 · 10th to 90th $20 to $2,239
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 $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $147.91 | Professional | None | $67.61 | $104.71 | $147.91 |
BCBS Texas Setting Facility Modifier None Typical Low $1,659.59 Median $4,073.80 Typical High $4,168.69 | Facility | None | $1,659.59 | $4,073.80 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $181.97 | Professional | None | $66.07 | $109.65 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $162.18 | Professional | None | $72.44 | $114.82 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,715.35 | $3,715.35 |
Moda Health Setting Facility Modifier None Typical Low $112.20 Median $1,698.24 Typical High $5,248.07 | Facility | None | $112.20 | $1,698.24 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $147.91 | Professional | None | $67.61 | $104.71 | $147.91 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $87.10 Typical High $107.15 | Professional | None | $14.79 | $87.10 | $107.15 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $213.80 | Facility | None | $67.61 | $117.49 | $213.80 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $158.49 | Professional | None | $72.44 | $117.49 | $158.49 |
United Setting Facility Modifier None Typical Low $177.83 Median $1,348.96 Typical High $2,691.53 | Facility | None | $177.83 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $63.10 Median $95.50 Typical High $154.88 | Professional | None | $63.10 | $95.50 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
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 $33.88 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $33.88 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $20.89 Typical High $27.54 | Professional | 53 · Discontinued | $13.49 | $20.89 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $77.62 Typical High $102.33 | Professional | 54 · Surgery only | $51.29 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.49 Typical High $20.42 | Professional | 55 · Aftercare only | $10.23 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.23 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.76 | $10.23 | $13.80 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | GC · Resident with teaching physician | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $52.48 Typical High $67.61 | Professional | 52 · Reduced service | $33.88 | $52.48 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $20.89 Typical High $26.92 | Professional | 53 · Discontinued | $13.49 | $20.89 | $26.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $79.43 Typical High $100.00 | Professional | 54 · Surgery only | $51.29 | $79.43 | $100.00 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.85 Typical High $19.95 | Professional | 55 · Aftercare only | $10.23 | $15.85 | $19.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.47 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.76 | $10.47 | $13.49 |
Where Texas sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 43rd of 51
$102
AK $282FL $87.10
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.