How much rates vary
Facilitymedian $117 · 10th to 90th $68 to $2,512Professionalmedian $89 · 10th to 90th $31 to $676
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 $107.15 Median $3,715.35 Typical High $9,120.11 | Facility | None | $107.15 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $79.43 Typical High $109.65 | Professional | None | $42.66 | $79.43 | $109.65 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $114.82 | Professional | None | $41.69 | $48.98 | $114.82 |
BCBS Texas Setting Facility Modifier None Typical Low $64.57 Median $102.33 Typical High $691.83 | Facility | None | $64.57 | $102.33 | $691.83 |
BCBS Texas Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $147.91 | Professional | None | $43.65 | $85.11 | $147.91 |
Baylor Scott & White Setting Facility Modifier None Typical Low $22.91 Median $58.88 Typical High $131.83 | Facility | None | $22.91 | $58.88 | $131.83 |
Christus Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
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 $46.77 Median $93.33 Typical High $144.54 | Professional | None | $46.77 | $93.33 | $144.54 |
Lucent Health Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | None | $676.08 | $676.08 | $794.33 |
Moda Health Setting Facility Modifier None Typical Low $50.12 Median $758.58 Typical High $5,128.61 | Facility | None | $50.12 | $758.58 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $81.28 Typical High $117.49 | Professional | None | $42.66 | $81.28 | $117.49 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $3,801.89 | Facility | None | $66.07 | $125.89 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $93.33 Typical High $144.54 | Professional | None | $46.77 | $93.33 | $144.54 |
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 $40.74 Median $75.86 Typical High $138.04 | Professional | None | $40.74 | $75.86 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
11 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 $21.38 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $21.38 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $15.85 Typical High $21.38 | Professional | 53 · Discontinued | $8.51 | $15.85 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $60.26 Typical High $79.43 | Professional | 54 · Surgery only | $32.36 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $12.02 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.27 | $7.94 | $10.72 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $39.81 Typical High $53.70 | Professional | 52 · Reduced service | $21.38 | $39.81 | $53.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $15.85 Typical High $21.38 | Professional | 53 · Discontinued | $8.51 | $15.85 | $21.38 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $60.26 Typical High $79.43 | Professional | 54 · Surgery only | $32.36 | $60.26 | $79.43 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $12.02 Typical High $15.85 | Professional | 55 · Aftercare only | $6.46 | $12.02 | $15.85 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $7.94 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.27 | $7.94 | $10.72 |
Moda Health Setting Professional Modifier 59 · Distinct service Typical Low $25.70 Median $87.10 Typical High $107.15 | Professional | 59 · Distinct service | $25.70 | $87.10 | $107.15 |
Where Texas sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 40th of 51
$91.20
AK $204KY $61.66
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.