How much rates vary
Facilitymedian $2,512 · 10th to 90th $191 to $10,471Professionalmedian $575 · 10th to 90th $85 to $4,677
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 $660.69 Median $3,715.35 Typical High $9,120.11 | Facility | None | $660.69 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $177.83 Typical High $741.31 | Professional | None | $69.18 | $177.83 | $741.31 |
BCBS Texas Setting Professional Modifier None Typical Low $87.10 Median $316.23 Typical High $1,047.13 | Professional | None | $87.10 | $316.23 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Facility | None | $85.11 | $85.11 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $213.80 Typical High $812.83 | Professional | None | $89.13 | $213.80 | $812.83 |
Lucent Health Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $6,165.95 | Professional | None | $4,677.35 | $4,677.35 | $6,165.95 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,230.27 Typical High $6,025.60 | Facility | None | $95.50 | $1,230.27 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $69.18 Median $199.53 Typical High $758.58 | Professional | None | $69.18 | $199.53 | $758.58 |
Molina Setting Professional Modifier None Typical Low $104.71 Median $602.56 Typical High $794.33 | Professional | None | $104.71 | $602.56 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $288.40 Typical High $2,630.27 | Professional | None | $89.13 | $288.40 | $2,630.27 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $144.54 Typical High $954.99 | Facility | None | $83.18 | $144.54 | $954.99 |
Providence Setting Professional Modifier None Typical Low $89.13 Median $229.09 Typical High $831.76 | Professional | None | $89.13 | $229.09 | $831.76 |
United Setting Facility Modifier None Typical Low $501.19 Median $2,754.23 Typical High $10,964.78 | Facility | None | $501.19 | $2,754.23 | $10,964.78 |
United Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $562.34 | Professional | None | $75.86 | $169.82 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $34.67 Median $89.13 Typical High $363.08 | Professional | 52 · Reduced service | $34.67 | $89.13 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $35.48 Typical High $144.54 | Professional | 53 · Discontinued | $13.80 | $35.48 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $134.90 Typical High $549.54 | Professional | 54 · Surgery only | $51.29 | $134.90 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $26.92 Typical High $109.65 | Professional | 55 · Aftercare only | $10.23 | $26.92 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $17.78 Typical High $72.44 | Professional | 56 · Pre-op care only | $6.92 | $17.78 | $72.44 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $97.72 Typical High $371.54 | Professional | 52 · Reduced service | $34.67 | $97.72 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $39.81 Typical High $147.91 | Professional | 53 · Discontinued | $13.80 | $39.81 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $147.91 Typical High $562.34 | Professional | 54 · Surgery only | $51.29 | $147.91 | $562.34 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $29.51 Typical High $112.20 | Professional | 55 · Aftercare only | $10.23 | $29.51 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $19.95 Typical High $74.13 | Professional | 56 · Pre-op care only | $6.92 | $19.95 | $74.13 |
Where Texas sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 6th of 51
$575
WA $933DC $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.