How much rates vary
Facilitymedian $182 · 10th to 90th $79 to $2,951Professionalmedian $24 · 10th to 90th $18 to $407
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 $23.99 Median $3,715.35 Typical High $9,120.11 | Facility | None | $23.99 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $53.70 | Professional | None | $19.50 | $23.44 | $53.70 |
Ambetter Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | None | $16.98 | $16.98 | $18.20 |
BCBS Texas Setting Facility Modifier None Typical Low $95.50 Median $190.55 Typical High $2,398.83 | Facility | None | $95.50 | $190.55 | $2,398.83 |
BCBS Texas Setting Professional Modifier None Typical Low $15.14 Median $20.89 Typical High $28.18 | Professional | None | $15.14 | $20.89 | $28.18 |
Christus Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
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 $17.78 Median $22.39 Typical High $56.23 | Professional | None | $17.78 | $22.39 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $660.69 | Professional | None | $407.38 | $660.69 | $660.69 |
Moda Health Setting Facility Modifier None Typical Low $19.05 Median $288.40 Typical High $5,128.61 | Facility | None | $19.05 | $288.40 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $53.70 | Professional | None | $19.50 | $23.44 | $53.70 |
Molina Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $44.67 | Professional | None | $38.02 | $41.69 | $44.67 |
Oscar Health Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $19.50 | Professional | None | $18.20 | $18.62 | $19.50 |
Providence Setting Facility Modifier None Typical Low $18.62 Median $50.12 Typical High $190.55 | Facility | None | $18.62 | $50.12 | $190.55 |
Providence Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $56.23 | Professional | None | $17.78 | $22.39 | $56.23 |
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 $21.88 Median $40.74 Typical High $63.10 | Professional | None | $21.88 | $40.74 | $63.10 |
Wellpoint Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | None | $18.20 | $18.62 | $18.62 |
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 $9.55 Median $11.22 Typical High $15.14 | Professional | 52 · Reduced service | $9.55 | $11.22 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.47 Typical High $6.03 | Professional | 53 · Discontinued | $3.89 | $4.47 | $6.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $16.60 Typical High $22.39 | Professional | 54 · Surgery only | $14.45 | $16.60 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.31 Typical High $4.47 | Professional | 55 · Aftercare only | $2.88 | $3.31 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.24 Typical High $3.02 | Professional | 56 · Pre-op care only | $1.95 | $2.24 | $3.02 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $11.22 Typical High $14.79 | Professional | 52 · Reduced service | $9.55 | $11.22 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $4.47 Typical High $5.89 | Professional | 53 · Discontinued | $3.89 | $4.47 | $5.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $14.45 Median $16.60 Typical High $21.88 | Professional | 54 · Surgery only | $14.45 | $16.60 | $21.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.31 Typical High $4.47 | Professional | 55 · Aftercare only | $2.88 | $3.31 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.24 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.95 | $2.24 | $2.95 |
Where Texas sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 46th of 51
$27.54
WY $89.13NY $20.89
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.