How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $6,607Professionalmedian $316 · 10th to 90th $49 to $3,236
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 $977.24 Median $3,311.31 Typical High $8,709.64 | Facility | None | $977.24 | $3,311.31 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $1,513.56 | Professional | None | $331.13 | $346.74 | $1,513.56 |
BCBS Texas Setting Facility Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,819.70 | $3,311.31 | $6,760.83 |
BCBS Texas Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $389.05 | Professional | None | $295.12 | $323.59 | $389.05 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $2,187.76 Typical High $2,884.03 | Facility | None | $691.83 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $616.60 | Professional | None | $346.74 | $398.11 | $616.60 |
Health Smart Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $363.08 Median $2,454.71 Typical High $6,025.60 | Facility | None | $363.08 | $2,454.71 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $501.19 | Professional | None | $331.13 | $338.84 | $501.19 |
Molina Setting Professional Modifier None Typical Low $44.67 Median $245.47 Typical High $331.13 | Professional | None | $44.67 | $245.47 | $331.13 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $2,238.72 Typical High $6,165.95 | Facility | None | $562.34 | $2,238.72 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $616.60 | Professional | None | $346.74 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $602.56 | Professional | None | $269.15 | $380.19 | $602.56 |
Wellpoint Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $165.96 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $66.07 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $39.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $169.82 | $199.53 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $66.07 | $67.61 | $79.43 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $245.47 | $251.19 | $295.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $48.98 | $50.12 | $58.88 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.11 | $33.88 | $39.81 |
Where Texas sits
The same service costs 4.7 times more in Alaska than in New York. 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· 49th of 51
$363
AK $1,622NY $347
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.