How much rates vary
Facilitymedian $3,020 · 10th to 90th $603 to $8,128Professionalmedian $363 · 10th to 90th $65 to $741
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $457.09 | Professional | None | $263.03 | $354.81 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $478.63 Typical High $478.63 | Professional | None | $234.42 | $478.63 | $478.63 |
BCBS Texas Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $10,471.29 | Facility | None | $1,258.93 | $3,467.37 | $10,471.29 |
BCBS Texas Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $724.44 | Professional | None | $275.42 | $416.87 | $724.44 |
Christus Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $3,715.35 | Facility | None | $645.65 | $2,630.27 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $616.60 | Professional | None | $288.40 | $398.11 | $616.60 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Moda Health Setting Facility Modifier None Typical Low $380.19 Median $2,570.40 Typical High $5,248.07 | Facility | None | $380.19 | $2,570.40 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $457.09 | Professional | None | $263.03 | $354.81 | $457.09 |
Molina Setting Professional Modifier None Typical Low $53.70 Median $302.00 Typical High $398.11 | Professional | None | $53.70 | $302.00 | $398.11 |
Providence Setting Facility Modifier None Typical Low $446.68 Median $2,570.40 Typical High $4,466.84 | Facility | None | $446.68 | $2,570.40 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $602.56 | Professional | None | $288.40 | $398.11 | $602.56 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,513.56 Typical High $5,623.41 | Facility | None | $389.05 | $1,513.56 | $5,623.41 |
United Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $575.44 | Professional | None | $245.47 | $371.54 | $575.44 |
Wellpoint Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $131.83 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $131.83 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $67.61 Typical High $91.20 | Professional | 53 · Discontinued | $52.48 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $251.19 Typical High $346.74 | Professional | 54 · Surgery only | $199.53 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $50.12 Typical High $69.18 | Professional | 55 · Aftercare only | $39.81 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $33.88 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $33.88 | $45.71 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $173.78 Typical High $229.09 | Professional | 52 · Reduced service | $131.83 | $173.78 | $229.09 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $52.48 | $69.18 | $91.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $346.74 | Professional | 54 · Surgery only | $199.53 | $263.03 | $346.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $69.18 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $69.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $34.67 | $45.71 |
Where Texas sits
The same service costs 3.9 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· 41st of 51
$407
AK $1,380NY $355
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.