How much rates vary
Facilitymedian $501 · 10th to 90th $95 to $3,715Professionalmedian $182 · 10th to 90th $35 to $1,318
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 $128.82 Median $162.18 Typical High $204.17 | Professional | None | $128.82 | $162.18 | $204.17 |
BCBS Texas Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $912.01 | Facility | None | $77.62 | $125.89 | $912.01 |
BCBS Texas Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $204.17 | Professional | None | $128.82 | $162.18 | $204.17 |
Christus Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $128.82 Typical High $1,412.54 | Facility | None | $91.20 | $128.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $281.84 | Professional | None | $144.54 | $190.55 | $281.84 |
Lucent Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
Moda Health Setting Facility Modifier None Typical Low $162.18 Median $1,047.13 Typical High $4,786.30 | Facility | None | $162.18 | $1,047.13 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $229.09 | Professional | None | $128.82 | $162.18 | $229.09 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $218.78 | Professional | None | $29.51 | $162.18 | $218.78 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $218.78 Typical High $3,801.89 | Facility | None | $107.15 | $218.78 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $281.84 | Professional | None | $147.91 | $194.98 | $281.84 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,288.25 Typical High $3,090.30 | Facility | None | $389.05 | $1,288.25 | $3,090.30 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $257.04 | Professional | None | $123.03 | $169.82 | $257.04 |
Wellpoint Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $64.57 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $97.72 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $16.22 | $20.42 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $64.57 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $81.28 | $102.33 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $32.36 | $40.74 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $151.36 | Professional | 54 · Surgery only | $97.72 | $120.23 | $151.36 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $30.20 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $30.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $16.22 | $20.42 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 41st of 51
$186
AK $575PA $170
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.