How much rates vary
Facilitymedian $204 · 10th to 90th $50 to $3,090Professionalmedian $69 · 10th to 90th $12 to $1,023
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 $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $70.79 Typical High $100.00 | Professional | None | $36.31 | $70.79 | $100.00 |
BCBS Texas Setting Facility Modifier None Typical Low $47.86 Median $81.28 Typical High $457.09 | Facility | None | $47.86 | $81.28 | $457.09 |
BCBS Texas Setting Professional Modifier None Typical Low $39.81 Median $72.44 Typical High $190.55 | Professional | None | $39.81 | $72.44 | $190.55 |
Christus Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $66.07 Typical High $1,412.54 | Facility | None | $47.86 | $66.07 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $144.54 | Professional | None | $46.77 | $83.18 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $57.54 Median $1,000.00 Typical High $4,570.88 | Facility | None | $57.54 | $1,000.00 | $4,570.88 |
Moda Health Setting Professional Modifier None Typical Low $36.31 Median $70.79 Typical High $97.72 | Professional | None | $36.31 | $70.79 | $97.72 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $57.54 Typical High $74.13 | Professional | None | $10.00 | $57.54 | $74.13 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $281.84 | Professional | None | $138.04 | $147.91 | $281.84 |
Providence Setting Facility Modifier None Typical Low $51.29 Median $104.71 Typical High $3,801.89 | Facility | None | $51.29 | $104.71 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $144.54 | Professional | None | $46.77 | $83.18 | $144.54 |
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 $41.69 Median $83.18 Typical High $158.49 | Professional | None | $41.69 | $83.18 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $18.20 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $18.20 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $14.13 Typical High $17.38 | Professional | 53 · Discontinued | $7.41 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $53.70 Typical High $64.57 | Professional | 54 · Surgery only | $27.54 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $5.50 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.63 | $7.08 | $8.71 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 59 · Distinct service | $72.44 | $72.44 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $34.67 Typical High $40.74 | Professional | 52 · Reduced service | $18.20 | $34.67 | $40.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $7.41 | $13.80 | $16.60 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $52.48 Typical High $61.66 | Professional | 54 · Surgery only | $27.54 | $52.48 | $61.66 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $10.47 Typical High $12.30 | Professional | 55 · Aftercare only | $5.50 | $10.47 | $12.30 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.63 | $6.92 | $8.32 |
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· 49th of 51
$70.79
AK $191VA $60.26
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.