How much rates vary
Facilitymedian $1,072 · 10th to 90th $155 to $3,890Professionalmedian $110 · 10th to 90th $22 to $398
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 $537.03 Median $2,238.72 Typical High $6,918.31 | Facility | None | $537.03 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $181.97 | Professional | None | $40.74 | $75.86 | $181.97 |
BCBS Texas Setting Facility Modifier None Typical Low $691.83 Median $1,380.38 Typical High $3,162.28 | Facility | None | $691.83 | $1,380.38 | $3,162.28 |
BCBS Texas Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $109.65 | Professional | None | $58.88 | $109.65 | $109.65 |
Christus Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Lucent Health Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | None | $831.76 | $1,258.93 | $1,258.93 |
Moda Health Setting Facility Modifier None Typical Low $63.10 Median $1,380.38 Typical High $5,128.61 | Facility | None | $63.10 | $1,380.38 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $181.97 | Professional | None | $40.74 | $79.43 | $181.97 |
Molina Setting Professional Modifier None Typical Low $19.50 Median $104.71 Typical High $144.54 | Professional | None | $19.50 | $104.71 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | None | $141.25 | $141.25 | $147.91 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $154.88 | Facility | None | $57.54 | $93.33 | $154.88 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,479.11 Typical High $1,949.84 | Facility | None | $1,412.54 | $1,479.11 | $1,949.84 |
United Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $158.49 | Professional | None | $57.54 | $97.72 | $158.49 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
8 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 $19.95 Median $37.15 Typical High $63.10 | Professional | 52 · Reduced service | $19.95 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $15.14 Typical High $25.12 | Professional | 53 · Discontinued | $8.13 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $11.22 Typical High $18.62 | Professional | 55 · Aftercare only | $6.03 | $11.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.07 | $7.59 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $37.15 Typical High $60.26 | Professional | 52 · Reduced service | $19.95 | $37.15 | $60.26 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $15.14 Typical High $23.99 | Professional | 53 · Discontinued | $8.13 | $15.14 | $23.99 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $11.22 Typical High $17.78 | Professional | 55 · Aftercare only | $6.03 | $11.22 | $17.78 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $7.59 Typical High $12.02 | Professional | 56 · Pre-op care only | $4.07 | $7.59 | $12.02 |
Where Texas sits
The same service costs 30.6 times more in California 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.
Physician feeFacility fee
CA $5,736KY $187
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.