How much rates vary
Facilitymedian $257 · 10th to 90th $81 to $2,291Professionalmedian $107 · 10th to 90th $26 to $269
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 $467.74 Median $2,187.76 Typical High $6,918.31 | Facility | None | $467.74 | $2,187.76 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $97.72 Typical High $123.03 | Professional | None | $41.69 | $97.72 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $138.04 | Professional | None | $67.61 | $75.86 | $138.04 |
BCBS Texas Setting Facility Modifier None Typical Low $75.86 Median $112.20 Typical High $707.95 | Facility | None | $75.86 | $112.20 | $707.95 |
BCBS Texas Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $165.96 | Professional | None | $47.86 | $102.33 | $165.96 |
Baylor Scott & White Setting Facility Modifier None Typical Low $47.86 Median $331.13 Typical High $4,168.69 | Facility | None | $47.86 | $331.13 | $4,168.69 |
Christus Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $128.82 Typical High $1,412.54 | Facility | None | $93.33 | $128.82 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $162.18 | Professional | None | $56.23 | $102.33 | $162.18 |
Health Smart Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,071.52 | Professional | None | $1,023.29 | $1,023.29 | $1,071.52 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $512.86 Typical High $4,168.69 | Facility | None | $69.18 | $512.86 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $41.69 Median $97.72 Typical High $123.03 | Professional | None | $41.69 | $97.72 | $123.03 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $109.65 Typical High $147.91 | Professional | None | $19.95 | $109.65 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $457.09 | Professional | None | $169.82 | $186.21 | $457.09 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $158.49 Typical High $3,801.89 | Facility | None | $89.13 | $158.49 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $100.00 Typical High $162.18 | Professional | None | $56.23 | $100.00 | $162.18 |
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 $46.77 Median $87.10 Typical High $147.91 | Professional | None | $46.77 | $87.10 | $147.91 |
Wellpoint Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $20.89 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $20.89 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $8.51 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $72.44 Typical High $87.10 | Professional | 54 · Surgery only | $31.62 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $14.45 Typical High $17.38 | Professional | 55 · Aftercare only | $6.31 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.17 | $9.55 | $11.48 |
Ambetter Setting Professional Modifier Q6 · Substitute physician, paid per time Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | Q6 · Substitute physician, paid per time | $114.82 | $114.82 | $114.82 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $46.77 Typical High $57.54 | Professional | 52 · Reduced service | $20.89 | $46.77 | $57.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $18.62 Typical High $22.91 | Professional | 53 · Discontinued | $8.51 | $18.62 | $22.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $70.79 Typical High $87.10 | Professional | 54 · Surgery only | $31.62 | $70.79 | $87.10 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $6.31 | $14.13 | $17.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.17 | $9.55 | $11.48 |
Where Texas sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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· 32nd of 51
$110
AK $234KY $69.18
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.