How much rates vary
Facilitymedian $339 · 10th to 90th $58 to $3,802Professionalmedian $83 · 10th to 90th $18 to $138
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 $93.33 Median $2,089.30 Typical High $6,760.83 | Facility | None | $93.33 | $2,089.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $123.03 | Professional | None | $41.69 | $87.10 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
BCBS Texas Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $1,047.13 | Facility | None | $50.12 | $87.10 | $1,047.13 |
BCBS Texas Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $134.90 | Professional | None | $39.81 | $81.28 | $134.90 |
Christus Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $131.83 | Professional | None | $44.67 | $83.18 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Moda Health Setting Facility Modifier None Typical Low $58.88 Median $1,000.00 Typical High $4,786.30 | Facility | None | $58.88 | $1,000.00 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $123.03 | Professional | None | $41.69 | $87.10 | $123.03 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $107.15 | Professional | None | $14.45 | $79.43 | $107.15 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | None | $229.09 | $245.47 | $245.47 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $1,949.84 Typical High $3,981.07 | Facility | None | $72.44 | $1,949.84 | $3,981.07 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $128.82 | Professional | None | $44.67 | $75.86 | $128.82 |
United Setting Facility Modifier None Typical Low $181.97 Median $1,348.96 Typical High $2,691.53 | Facility | None | $181.97 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $134.90 | Professional | None | $40.74 | $79.43 | $134.90 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
21 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 Facility Modifier 52 · Reduced service Typical Low $20.89 Median $35.48 Typical High $93.33 | Facility | 52 · Reduced service | $20.89 | $35.48 | $93.33 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $14.13 Typical High $37.15 | Facility | 53 · Discontinued | $8.32 | $14.13 | $37.15 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $31.62 Median $53.70 Typical High $141.25 | Facility | 54 · Surgery only | $31.62 | $53.70 | $141.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $10.72 Typical High $28.18 | Facility | 55 · Aftercare only | $6.31 | $10.72 | $28.18 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.08 Typical High $18.62 | Facility | 56 · Pre-op care only | $4.17 | $7.08 | $18.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $42.66 Typical High $58.88 | Professional | 52 · Reduced service | $20.89 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $16.98 Typical High $23.44 | Professional | 53 · Discontinued | $8.32 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $64.57 Typical High $89.13 | Professional | 54 · Surgery only | $31.62 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $6.31 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $8.51 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.17 | $8.51 | $11.75 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $20.89 Median $27.54 Typical High $93.33 | Facility | 52 · Reduced service | $20.89 | $27.54 | $93.33 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $8.32 Median $10.96 Typical High $37.15 | Facility | 53 · Discontinued | $8.32 | $10.96 | $37.15 |
Moda Health Setting Facility Modifier 54 · Surgery only Typical Low $31.62 Median $40.74 Typical High $141.25 | Facility | 54 · Surgery only | $31.62 | $40.74 | $141.25 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $8.32 Typical High $28.18 | Facility | 55 · Aftercare only | $6.31 | $8.32 | $28.18 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.08 Typical High $18.62 | Facility | 56 · Pre-op care only | $4.57 | $7.08 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $41.69 Typical High $53.70 | Professional | 52 · Reduced service | $20.89 | $41.69 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $16.98 Typical High $21.38 | Professional | 53 · Discontinued | $8.32 | $16.98 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $63.10 Typical High $79.43 | Professional | 54 · Surgery only | $31.62 | $63.10 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $12.59 Typical High $15.85 | Professional | 55 · Aftercare only | $6.31 | $12.59 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $8.32 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.17 | $8.32 | $10.72 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $4.47 Median $26.30 Typical High $851.14 | Professional | 59 · Distinct service | $4.47 | $26.30 | $851.14 |
Where Texas sits
The same service costs 2.5 times more in North Carolina 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· 42nd of 51
$85.11
NC $174FL $70.79
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.