How much rates vary
Facilitymedian $7,762 · 10th to 90th $2,188 to $17,378Professionalmedian $2,818 · 10th to 90th $741 to $19,055
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 $1,584.89 Median $3,981.07 Typical High $24,547.09 | Facility | None | $1,584.89 | $3,981.07 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,290.87 | $3,019.95 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,698.24 | $3,235.94 |
BCBS Texas Setting Facility Modifier None Typical Low $3,715.35 Median $8,511.38 Typical High $12,022.64 | Facility | None | $3,715.35 | $8,511.38 | $12,022.64 |
BCBS Texas Setting Professional Modifier None Typical Low $741.31 Median $1,995.26 Typical High $1,995.26 | Professional | None | $741.31 | $1,995.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Lucent Health Setting Professional Modifier None Typical Low $19,054.61 Median $28,183.83 Typical High $28,183.83 | Professional | None | $19,054.61 | $28,183.83 | $28,183.83 |
Moda Health Setting Facility Modifier None Typical Low $1,584.89 Median $3,981.07 Typical High $51,286.14 | Facility | None | $1,584.89 | $3,981.07 | $51,286.14 |
Moda Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $2,818.38 | Professional | None | $1,584.89 | $2,290.87 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $2,398.83 Typical High $2,754.23 | Professional | None | $30.20 | $2,398.83 | $2,754.23 |
Providence Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $3,715.35 | Facility | None | $1,584.89 | $2,754.23 | $3,715.35 |
Providence Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,290.87 Median $7,585.78 Typical High $15,135.61 | Facility | None | $2,290.87 | $7,585.78 | $15,135.61 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $4,466.84 | Professional | None | $1,584.89 | $2,951.21 | $4,466.84 |
Wellpoint Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
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 $794.33 Median $1,023.29 Typical High $1,318.26 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $416.87 Typical High $524.81 | Professional | 53 · Discontinued | $316.23 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $398.11 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $208.93 Typical High $263.03 | Professional | 56 · Pre-op care only | $158.49 | $208.93 | $263.03 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $1,023.29 Typical High $1,318.26 | Professional | 52 · Reduced service | $794.33 | $1,023.29 | $1,318.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $416.87 Typical High $524.81 | Professional | 53 · Discontinued | $316.23 | $416.87 | $524.81 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,949.84 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $398.11 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $398.11 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $208.93 Typical High $263.03 | Professional | 56 · Pre-op care only | $158.49 | $208.93 | $263.03 |
Where Texas sits
The same service costs 14.1 times more in Alaska than in Missouri. 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· 35th of 51
$2,951
AK $8,511MO $603
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.