How much rates vary
Facilitymedian $646 · 10th to 90th $112 to $3,631Professionalmedian $110 · 10th to 90th $72 to $1,122
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 $125.89 Median $3,715.35 Typical High $9,120.11 | Facility | None | $125.89 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $154.88 | Professional | None | $100.00 | $114.82 | $154.88 |
BCBS Texas Setting Facility Modifier None Typical Low $288.40 Median $616.60 Typical High $3,162.28 | Facility | None | $288.40 | $616.60 | $3,162.28 |
BCBS Texas Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $158.49 | Professional | None | $91.20 | $117.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $109.65 Typical High $154.88 | Professional | None | $95.50 | $109.65 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $1,122.02 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,122.02 | $2,290.87 | $2,290.87 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $645.65 Typical High $5,248.07 | Facility | None | $91.20 | $645.65 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $158.49 | Professional | None | $100.00 | $114.82 | $158.49 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $83.18 Typical High $109.65 | Professional | None | $14.79 | $83.18 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $112.20 Typical High $338.84 | Facility | None | $50.12 | $112.20 | $338.84 |
Providence Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $154.88 | Professional | None | $95.50 | $112.20 | $154.88 |
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 $83.18 Median $109.65 Typical High $154.88 | Professional | None | $83.18 | $109.65 | $154.88 |
Wellpoint Setting Professional Modifier None Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | None | $112.20 | $114.82 | $114.82 |
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 $50.12 Median $57.54 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $57.54 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $75.86 | $87.10 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $14.45 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $57.54 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $57.54 | $72.44 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $22.91 Typical High $28.84 | Professional | 53 · Discontinued | $20.42 | $22.91 | $28.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $87.10 Typical High $107.15 | Professional | 54 · Surgery only | $75.86 | $87.10 | $107.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $17.38 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $17.38 | $21.38 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $14.45 |
Where Texas sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 42nd of 51
$115
AK $407FL $91.20
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.