How much rates vary
Facilitymedian $269 · 10th to 90th $65 to $3,631Professionalmedian $39 · 10th to 90th $22 to $63
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 $45.71 Median $3,715.35 Typical High $9,120.11 | Facility | None | $45.71 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $54.95 | Professional | None | $33.88 | $42.66 | $54.95 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
BCBS Texas Setting Facility Modifier None Typical Low $100.00 Median $218.78 Typical High $2,570.40 | Facility | None | $100.00 | $218.78 | $2,570.40 |
BCBS Texas Setting Professional Modifier None Typical Low $31.62 Median $39.81 Typical High $63.10 | Professional | None | $31.62 | $39.81 | $63.10 |
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 $32.36 Median $38.90 Typical High $56.23 | Professional | None | $32.36 | $38.90 | $56.23 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Moda Health Setting Facility Modifier None Typical Low $33.88 Median $707.95 Typical High $5,248.07 | Facility | None | $33.88 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $54.95 | Professional | None | $33.88 | $42.66 | $54.95 |
Molina Setting Professional Modifier None Typical Low $4.90 Median $26.92 Typical High $36.31 | Professional | None | $4.90 | $26.92 | $36.31 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Providence Setting Facility Modifier None Typical Low $33.88 Median $57.54 Typical High $151.36 | Facility | None | $33.88 | $57.54 | $151.36 |
Providence Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $56.23 | Professional | None | $32.36 | $38.90 | $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 $28.18 Median $38.90 Typical High $56.23 | Professional | None | $28.18 | $38.90 | $56.23 |
Wellpoint Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | None | $39.81 | $41.69 | $41.69 |
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 $16.98 Median $20.89 Typical High $25.70 | Professional | 52 · Reduced service | $16.98 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.51 Typical High $10.23 | Professional | 53 · Discontinued | $6.76 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $31.62 Typical High $38.90 | Professional | 54 · Surgery only | $25.70 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $5.13 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.27 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.39 | $4.27 | $5.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $20.89 Typical High $25.70 | Professional | 52 · Reduced service | $16.98 | $20.89 | $25.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $8.51 Typical High $10.23 | Professional | 53 · Discontinued | $6.76 | $8.51 | $10.23 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $31.62 Typical High $38.90 | Professional | 54 · Surgery only | $25.70 | $31.62 | $38.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.31 Typical High $7.76 | Professional | 55 · Aftercare only | $5.13 | $6.31 | $7.76 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $4.27 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.39 | $4.27 | $5.13 |
Where Texas sits
The same service costs 3.8 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· 45th of 51
$39.81
AK $135UT $35.48
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.