How much rates vary
Facilitymedian $1,862 · 10th to 90th $646 to $4,365Professionalmedian $224 · 10th to 90th $48 to $1,778
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 $512.86 Median $2,238.72 Typical High $6,918.31 | Facility | None | $512.86 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $281.84 | Professional | None | $100.00 | $213.80 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
BCBS Texas Setting Facility Modifier None Typical Low $933.25 Median $2,089.30 Typical High $4,073.80 | Facility | None | $933.25 | $2,089.30 | $4,073.80 |
BCBS Texas Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $380.19 | Professional | None | $109.65 | $190.55 | $380.19 |
Christus Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $371.54 | Professional | None | $123.03 | $229.09 | $371.54 |
Health Smart Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,778.28 | $2,089.30 | $2,089.30 |
Moda Health Setting Facility Modifier None Typical Low $331.13 Median $2,187.76 Typical High $4,265.80 | Facility | None | $331.13 | $2,187.76 | $4,265.80 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $288.40 | Professional | None | $100.00 | $213.80 | $288.40 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $199.53 Typical High $251.19 | Professional | None | $34.67 | $199.53 | $251.19 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $6,025.60 Typical High $10,715.19 | Facility | None | $162.18 | $6,025.60 | $10,715.19 |
Providence Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $371.54 | Professional | None | $123.03 | $229.09 | $371.54 |
United Setting Facility Modifier None Typical Low $446.68 Median $2,187.76 Typical High $3,801.89 | Facility | None | $446.68 | $2,187.76 | $3,801.89 |
United Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $363.08 | Professional | None | $109.65 | $208.93 | $363.08 |
Wellpoint Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $50.12 Median $97.72 Typical High $134.90 | Professional | 52 · Reduced service | $50.12 | $97.72 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $38.90 Typical High $54.95 | Professional | 53 · Discontinued | $19.95 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $75.86 | $147.91 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $15.14 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.05 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.00 | $19.05 | $27.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $100.00 Typical High $138.04 | Professional | 52 · Reduced service | $50.12 | $100.00 | $138.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $39.81 Typical High $54.95 | Professional | 53 · Discontinued | $19.95 | $39.81 | $54.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $147.91 Typical High $204.17 | Professional | 54 · Surgery only | $75.86 | $147.91 | $204.17 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $30.20 Typical High $40.74 | Professional | 55 · Aftercare only | $15.14 | $30.20 | $40.74 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $19.95 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.00 | $19.95 | $27.54 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 35th of 51
$234
AK $513VA $151
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.