How much rates vary
Facilitymedian $3,631 · 10th to 90th $575 to $12,589Professionalmedian $631 · 10th to 90th $234 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 $691.83 Median $2,398.83 Typical High $6,918.31 | Facility | None | $691.83 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $660.69 | Professional | None | $489.78 | $537.03 | $660.69 |
Ambetter Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
BCBS Texas Setting Facility Modifier None Typical Low $302.00 Median $6,025.60 Typical High $19,498.45 | Facility | None | $302.00 | $6,025.60 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,548.13 Typical High $6,760.83 | Facility | None | $660.69 | $3,548.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $891.25 | Professional | None | $537.03 | $676.08 | $891.25 |
Lucent Health Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,073.80 | $4,786.30 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,819.70 Typical High $5,495.41 | Facility | None | $512.86 | $1,819.70 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $602.56 | Professional | None | $489.78 | $524.81 | $602.56 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $74.13 Typical High $426.58 | Professional | None | $64.57 | $74.13 | $426.58 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $6,025.60 Typical High $12,589.25 | Facility | None | $602.56 | $6,025.60 | $12,589.25 |
Providence Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $891.25 | Professional | None | $537.03 | $676.08 | $891.25 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,737.80 | $4,897.79 | $10,471.29 |
United Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $501.19 | Professional | None | $251.19 | $331.13 | $501.19 |
Wellpoint Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $245.47 Median $269.15 Typical High $309.03 | Professional | 52 · Reduced service | $245.47 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $61.66 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $269.15 | $302.00 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $107.15 | $120.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $457.09 | Professional | 54 · Surgery only | $363.08 | $407.38 | $457.09 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $91.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $60.26 |
Where Texas sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 24th of 51
$676
AK $2,344HI $224
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.