How much rates vary
Facilitymedian $1,479 · 10th to 90th $186 to $4,467Professionalmedian $537 · 10th to 90th $83 to $4,169
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $724.44 | Professional | None | $501.19 | $562.34 | $724.44 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $4,265.80 Typical High $4,466.84 | Facility | None | $2,041.74 | $4,265.80 | $4,466.84 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $933.25 | Professional | None | $537.03 | $676.08 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $870.96 Typical High $2,691.53 | Facility | None | $446.68 | $870.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,466.84 | Professional | None | $4,168.69 | $4,168.69 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $549.54 Median $1,905.46 Typical High $5,495.41 | Facility | None | $549.54 | $1,905.46 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $707.95 | Professional | None | $501.19 | $562.34 | $707.95 |
Molina Setting Professional Modifier None Typical Low $74.13 Median $426.58 Typical High $549.54 | Professional | None | $74.13 | $426.58 | $549.54 |
Providence Setting Facility Modifier None Typical Low $501.19 Median $851.14 Typical High $2,691.53 | Facility | None | $501.19 | $851.14 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $977.24 | Professional | None | $549.54 | $676.08 | $977.24 |
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 $467.74 Median $602.56 Typical High $891.25 | Professional | None | $467.74 | $602.56 | $891.25 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $251.19 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $63.10 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $251.19 | $275.42 | $316.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $112.20 | $125.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $416.87 Typical High $467.74 | Professional | 54 · Surgery only | $371.54 | $416.87 | $467.74 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $93.33 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $93.33 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $54.95 | $63.10 |
Where Texas sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 50th of 51
$537
AK $2,399UT $490
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.