How much rates vary
Facilitymedian $117 · 10th to 90th $42 to $2,630Professionalmedian $76 · 10th to 90th $12 to $166
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 $61.66 Median $87.10 Typical High $123.03 | Professional | None | $61.66 | $87.10 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $54.95 | Professional | None | $33.11 | $54.95 | $54.95 |
BCBS Texas Setting Facility Modifier None Typical Low $37.15 Median $56.23 Typical High $371.54 | Facility | None | $37.15 | $56.23 | $371.54 |
BCBS Texas Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $141.25 | Professional | None | $60.26 | $87.10 | $141.25 |
Christus Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $67.61 Typical High $1,412.54 | Facility | None | $47.86 | $67.61 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $134.90 | Professional | None | $66.07 | $91.20 | $134.90 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Moda Health Setting Facility Modifier None Typical Low $67.61 Median $1,202.26 Typical High $6,456.54 | Facility | None | $67.61 | $1,202.26 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $120.23 | Professional | None | $61.66 | $87.10 | $120.23 |
Molina Setting Professional Modifier None Typical Low $9.77 Median $53.70 Typical High $72.44 | Professional | None | $9.77 | $53.70 | $72.44 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $107.15 Typical High $3,801.89 | Facility | None | $54.95 | $107.15 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $138.04 | Professional | None | $66.07 | $91.20 | $138.04 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $123.03 | Professional | None | $54.95 | $79.43 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $30.20 Median $41.69 Typical High $47.86 | Professional | 52 · Reduced service | $30.20 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $12.30 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $70.79 | Professional | 54 · Surgery only | $45.71 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $14.13 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.32 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.17 | $8.32 | $9.55 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $30.20 | $41.69 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.98 Typical High $19.05 | Professional | 53 · Discontinued | $12.30 | $16.98 | $19.05 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $63.10 Typical High $70.79 | Professional | 54 · Surgery only | $45.71 | $63.10 | $70.79 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $14.13 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.32 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.17 | $8.32 | $9.33 |
Where Texas sits
The same service costs 3.5 times more in Wisconsin 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· 49th of 51
$79.43
WI $269FL $75.86
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.