How much rates vary
Facilitymedian $372 · 10th to 90th $72 to $2,818Professionalmedian $110 · 10th to 90th $23 to $182
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 $46.77 Median $100.00 Typical High $141.25 | Professional | None | $46.77 | $100.00 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $112.20 | Professional | None | $60.26 | $107.15 | $112.20 |
BCBS Texas Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $691.83 | Facility | None | $64.57 | $100.00 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $50.12 Median $100.00 Typical High $213.80 | Professional | None | $50.12 | $100.00 | $213.80 |
Christus Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $123.03 Typical High $1,412.54 | Facility | None | $87.10 | $123.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $112.20 Typical High $158.49 | Professional | None | $57.54 | $112.20 | $158.49 |
Lucent Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Moda Health Setting Facility Modifier None Typical Low $75.86 Median $870.96 Typical High $4,168.69 | Facility | None | $75.86 | $870.96 | $4,168.69 |
Moda Health Setting Professional Modifier None Typical Low $46.77 Median $100.00 Typical High $141.25 | Professional | None | $46.77 | $100.00 | $141.25 |
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 $181.97 Median $190.55 Typical High $446.68 | Professional | None | $181.97 | $190.55 | $446.68 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $3,801.89 | Facility | None | $87.10 | $158.49 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $112.20 Typical High $158.49 | Professional | None | $57.54 | $112.20 | $158.49 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,230.27 Typical High $3,235.94 | Facility | None | $389.05 | $1,230.27 | $3,235.94 |
United Setting Professional Modifier None Typical Low $52.48 Median $102.33 Typical High $158.49 | Professional | None | $52.48 | $102.33 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
12 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 $23.44 Median $47.86 Typical High $56.23 | Professional | 52 · Reduced service | $23.44 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $9.33 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $72.44 Typical High $85.11 | Professional | 54 · Surgery only | $35.48 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $14.45 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $9.55 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.68 | $9.55 | $11.22 |
Moda Health Setting Facility Modifier 50 · Both sides Typical Low $831.76 Median $870.96 Typical High $1,819.70 | Facility | 50 · Both sides | $831.76 | $870.96 | $1,819.70 |
Moda Health Setting Facility Modifier XP · Separate practitioner Typical Low $891.25 Median $1,202.26 Typical High $1,778.28 | Facility | XP · Separate practitioner | $891.25 | $1,202.26 | $1,778.28 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $47.86 Typical High $56.23 | Professional | 52 · Reduced service | $23.44 | $47.86 | $56.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $9.33 | $19.05 | $22.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $72.44 Typical High $85.11 | Professional | 54 · Surgery only | $35.48 | $72.44 | $85.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $14.45 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $14.45 | $16.98 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $9.55 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.68 | $9.55 | $11.22 |
Where Texas sits
The same service costs 3.2 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· 36th of 51
$112
AK $263VA $81.28
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.