How much rates vary
Facilitymedian $219 · 10th to 90th $78 to $4,169Professionalmedian $129 · 10th to 90th $25 to $933
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 $141.25 Median $3,715.35 Typical High $9,120.11 | Facility | None | $141.25 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $112.20 Typical High $158.49 | Professional | None | $53.70 | $112.20 | $158.49 |
BCBS Texas Setting Facility Modifier None Typical Low $89.13 Median $204.17 Typical High $363.08 | Facility | None | $89.13 | $204.17 | $363.08 |
BCBS Texas Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $269.15 | Professional | None | $52.48 | $81.28 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $138.04 | Facility | None | $67.61 | $67.61 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $213.80 | Professional | None | $64.57 | $134.90 | $213.80 |
Lucent Health Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Moda Health Setting Facility Modifier None Typical Low $70.79 Median $1,737.80 Typical High $6,025.60 | Facility | None | $70.79 | $1,737.80 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $53.70 Median $112.20 Typical High $165.96 | Professional | None | $53.70 | $112.20 | $165.96 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $114.82 Typical High $144.54 | Professional | None | $19.95 | $114.82 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $562.34 | Professional | None | $194.98 | $204.17 | $562.34 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $104.71 Typical High $194.98 | Facility | None | $60.26 | $104.71 | $194.98 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $138.04 Typical High $208.93 | Professional | None | $64.57 | $138.04 | $208.93 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $58.88 | Facility | None | $43.65 | $43.65 | $58.88 |
United Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $199.53 | Professional | None | $58.88 | $114.82 | $199.53 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $26.92 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $26.92 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $10.72 | $22.39 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $39.81 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $7.94 | $16.98 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.37 | $11.22 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $56.23 Typical High $75.86 | Professional | 52 · Reduced service | $25.12 | $56.23 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $22.39 Typical High $30.20 | Professional | 53 · Discontinued | $10.00 | $22.39 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $85.11 Typical High $114.82 | Professional | 54 · Surgery only | $37.15 | $85.11 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $16.98 Typical High $22.91 | Professional | 55 · Aftercare only | $7.41 | $16.98 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $11.22 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.01 | $11.22 | $15.14 |
Where Texas sits
The same service costs 3.5 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· 42nd of 51
$129
AK $263KY $75.86
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.