How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,778 to $9,772Professionalmedian $309 · 10th to 90th $50 to $4,786
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 $3,548.13 Typical High $8,511.38 | Facility | None | $977.24 | $3,548.13 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $446.68 | Professional | None | $288.40 | $309.03 | $446.68 |
BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $4,365.16 Typical High $11,481.54 | Facility | None | $2,089.30 | $4,365.16 | $11,481.54 |
BCBS Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $724.44 | Professional | None | $281.84 | $363.08 | $724.44 |
Christus Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Facility | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $3,715.35 | Facility | None | $707.95 | $2,691.53 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $630.96 | Professional | None | $309.03 | $363.08 | $630.96 |
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 $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $7,943.28 | Facility | None | $436.52 | $3,235.94 | $7,943.28 |
Moda Health Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $446.68 | Professional | None | $288.40 | $309.03 | $446.68 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $245.47 Typical High $331.13 | Professional | None | $43.65 | $245.47 | $331.13 |
Providence Setting Facility Modifier None Typical Low $588.84 Median $2,754.23 Typical High $6,165.95 | Facility | None | $588.84 | $2,754.23 | $6,165.95 |
Providence Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $630.96 | Professional | None | $309.03 | $363.08 | $630.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $10,000.00 | Facility | None | $1,698.24 | $4,570.88 | $10,000.00 |
United Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $562.34 | Professional | None | $263.03 | $363.08 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
11 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 $141.25 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $141.25 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $36.31 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 59 · Distinct service | $407.38 | $407.38 | $407.38 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $141.25 | $154.88 | $181.97 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $56.23 | $61.66 | $72.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $234.42 Typical High $269.15 | Professional | 54 · Surgery only | $208.93 | $234.42 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $46.77 Typical High $53.70 | Professional | 55 · Aftercare only | $41.69 | $46.77 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.18 | $30.90 | $36.31 |
Where Texas sits
The same service costs 10.0 times more in Oklahoma 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· 47th of 51
$398
OK $2,884NY $288
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.