How much rates vary
Facilitymedian $741 · 10th to 90th $174 to $3,715Professionalmedian $251 · 10th to 90th $46 to $550
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 $2,187.76 Typical High $6,760.83 | Facility | None | $575.44 | $2,187.76 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $363.08 | Professional | None | $194.98 | $239.88 | $363.08 |
BCBS Texas Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $575.44 | Professional | None | $199.53 | $295.12 | $575.44 |
Christus Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $239.88 Typical High $1,479.11 | Facility | None | $169.82 | $239.88 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $389.05 | Professional | None | $213.80 | $269.15 | $389.05 |
Health Smart Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $245.47 Median $1,047.13 Typical High $4,677.35 | Facility | None | $245.47 | $1,047.13 | $4,677.35 |
Moda Health Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $363.08 | Professional | None | $194.98 | $245.47 | $363.08 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $213.80 Typical High $288.40 | Professional | None | $38.90 | $213.80 | $288.40 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $363.08 Typical High $3,801.89 | Facility | None | $190.55 | $363.08 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $389.05 | Professional | None | $208.93 | $269.15 | $389.05 |
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 $177.83 Median $245.47 Typical High $371.54 | Professional | None | $177.83 | $245.47 | $371.54 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $97.72 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $30.20 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $97.72 | $120.23 | $151.36 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $38.90 | $47.86 | $60.26 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $223.87 | Professional | 54 · Surgery only | $144.54 | $181.97 | $223.87 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $45.71 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $45.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.99 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.50 | $23.99 | $30.20 |
Where Texas sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 43rd of 51
$257
AK $851MD $229
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.