How much rates vary
Facilitymedian $437 · 10th to 90th $107 to $2,188Professionalmedian $129 · 10th to 90th $22 to $214
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | None | $112.20 | $134.90 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
BCBS Texas Setting Facility Modifier None Typical Low $218.78 Median $512.86 Typical High $933.25 | Facility | None | $218.78 | $512.86 | $933.25 |
BCBS Texas Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $218.78 | Professional | None | $107.15 | $131.83 | $218.78 |
Christus Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $158.49 Typical High $316.23 | Facility | None | $112.20 | $158.49 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $190.55 | Professional | None | $102.33 | $141.25 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Moda Health Setting Facility Modifier None Typical Low $123.03 Median $1,148.15 Typical High $6,025.60 | Facility | None | $123.03 | $1,148.15 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $186.21 | Professional | None | $112.20 | $134.90 | $186.21 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $107.15 Typical High $144.54 | Professional | None | $19.50 | $107.15 | $144.54 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $218.78 | Facility | None | $107.15 | $138.04 | $218.78 |
Providence Setting Professional Modifier None Typical Low $102.33 Median $141.25 Typical High $190.55 | Professional | None | $102.33 | $141.25 | $190.55 |
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 $102.33 Median $134.90 Typical High $194.98 | Professional | None | $102.33 | $134.90 | $194.98 |
Wellpoint Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Professional | None | $128.82 | $128.82 | $128.82 |
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 $56.23 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $100.00 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $15.14 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $56.23 | $66.07 | $75.86 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $26.30 Typical High $30.20 | Professional | 53 · Discontinued | $22.39 | $26.30 | $30.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $100.00 Typical High $114.82 | Professional | 54 · Surgery only | $85.11 | $100.00 | $114.82 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $22.91 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $15.14 |
Where Texas sits
The same service costs 3.2 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· 45th of 51
$132
AK $347KY $107
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.