How much rates vary
Facilitymedian $195 · 10th to 90th $56 to $2,399Professionalmedian $107 · 10th to 90th $74 to $501
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 $91.20 Median $114.82 Typical High $154.88 | Professional | None | $91.20 | $114.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $109.65 Typical High $117.49 | Professional | None | $37.15 | $109.65 | $117.49 |
BCBS Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $478.63 | Facility | None | $47.86 | $72.44 | $478.63 |
BCBS Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $141.25 | Professional | None | $74.13 | $104.71 | $141.25 |
Baylor Scott & White Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $134.90 | Professional | None | $112.20 | $131.83 | $134.90 |
Christus Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $91.20 Typical High $1,412.54 | Facility | None | $64.57 | $91.20 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $154.88 | Professional | None | $87.10 | $107.15 | $154.88 |
Health Smart Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $501.19 | Professional | None | $138.04 | $169.82 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $436.52 Median $1,778.28 Typical High $3,235.94 | Professional | None | $436.52 | $1,778.28 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $933.25 Typical High $4,365.16 | Facility | None | $109.65 | $933.25 | $4,365.16 |
Moda Health Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $162.18 | Professional | None | $91.20 | $114.82 | $162.18 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $83.18 Typical High $112.20 | Professional | None | $14.79 | $83.18 | $112.20 |
Oscar Health Setting Facility Modifier None Typical Low $79.43 Median $97.72 Typical High $2,630.27 | Facility | None | $79.43 | $97.72 | $2,630.27 |
Oscar Health Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $239.88 | Professional | None | $81.28 | $151.36 | $239.88 |
Providence Setting Facility Modifier None Typical Low $74.13 Median $158.49 Typical High $3,801.89 | Facility | None | $74.13 | $158.49 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $154.88 | Professional | None | $87.10 | $107.15 | $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 $77.62 Median $109.65 Typical High $204.17 | Professional | None | $77.62 | $109.65 | $204.17 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | None | $109.65 | $114.82 | $114.82 |
14 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 $45.71 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $67.61 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $11.48 | $13.80 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $165.96 Typical High $177.83 | Professional | 50 · Both sides | $147.91 | $165.96 | $177.83 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 58 · Staged procedure | $208.93 | $208.93 | $208.93 |
Ambetter Setting Professional Modifier 79 · Unrelated procedure after surgery Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 79 · Unrelated procedure after surgery | $165.96 | $165.96 | $165.96 |
Moda Health Setting Professional Modifier 50 · Both sides Typical Low $158.49 Median $302.00 Typical High $524.81 | Professional | 50 · Both sides | $158.49 | $302.00 | $524.81 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $45.71 | $57.54 | $69.18 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $22.91 | $27.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $67.61 | $85.11 | $104.71 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $16.98 | $20.89 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $11.48 | $13.80 |
Where Texas sits
The same service costs 3.7 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· 47th of 51
$110
AK $363FL $97.72
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.