How much rates vary
Facilitymedian $158 · 10th to 90th $79 to $525Professionalmedian $63 · 10th to 90th $5 to $115
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 $75.86 Median $147.91 Typical High $588.84 | Facility | None | $75.86 | $147.91 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $169.82 | Professional | None | $67.61 | $75.86 | $169.82 |
Ambetter Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $70.79 | Professional | None | $39.81 | $57.54 | $70.79 |
BCBS Texas Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $660.69 | Facility | None | $125.89 | $354.81 | $660.69 |
BCBS Texas Setting Professional Modifier None Typical Low $5.01 Median $63.10 Typical High $75.86 | Professional | None | $5.01 | $63.10 | $75.86 |
Christus Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $239.88 Typical High $354.81 | Facility | None | $63.10 | $239.88 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $120.23 | Professional | None | $60.26 | $60.26 | $120.23 |
Health Smart Setting Professional Modifier None Typical Low $97.72 Median $120.23 Typical High $165.96 | Professional | None | $97.72 | $120.23 | $165.96 |
Lucent Health Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $173.78 | Professional | None | $102.33 | $128.82 | $173.78 |
Moda Health Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $416.87 | Facility | None | $66.07 | $138.04 | $416.87 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $138.04 | Professional | None | $57.54 | $85.11 | $138.04 |
Molina Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | None | $85.11 | $95.50 | $95.50 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $120.23 Typical High $354.81 | Facility | None | $72.44 | $120.23 | $354.81 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Professional | None | $60.26 | $60.26 | $75.86 |
United Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $114.82 | Facility | None | $40.74 | $47.86 | $114.82 |
United Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $69.18 | Professional | None | $33.88 | $47.86 | $69.18 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $58.88 | Professional | None | $31.62 | $31.62 | $58.88 |
21 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 Facility Modifier 52 · Reduced service Typical Low $38.02 Median $83.18 Typical High $309.03 | Facility | 52 · Reduced service | $38.02 | $83.18 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $33.11 Typical High $123.03 | Facility | 53 · Discontinued | $15.14 | $33.11 | $123.03 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $56.23 Median $123.03 Typical High $467.74 | Facility | 54 · Surgery only | $56.23 | $123.03 | $467.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $24.55 Typical High $93.33 | Facility | 55 · Aftercare only | $11.22 | $24.55 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $16.60 Typical High $61.66 | Facility | 56 · Pre-op care only | $7.59 | $16.60 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $38.02 Typical High $69.18 | Professional | 52 · Reduced service | $34.67 | $38.02 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.14 Typical High $27.54 | Professional | 53 · Discontinued | $13.80 | $15.14 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $53.70 Typical High $104.71 | Professional | 54 · Surgery only | $51.29 | $53.70 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $20.89 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.59 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.92 | $7.59 | $13.80 |
Moda Health Setting Facility Modifier 52 · Reduced service Typical Low $43.65 Median $83.18 Typical High $309.03 | Facility | 52 · Reduced service | $43.65 | $83.18 | $309.03 |
Moda Health Setting Facility Modifier 53 · Discontinued Typical Low $17.38 Median $33.11 Typical High $123.03 | Facility | 53 · Discontinued | $17.38 | $33.11 | $123.03 |
Moda Health Setting Facility Modifier 54 · Surgery only Typical Low $64.57 Median $123.03 Typical High $467.74 | Facility | 54 · Surgery only | $64.57 | $123.03 | $467.74 |
Moda Health Setting Facility Modifier 55 · Aftercare only Typical Low $12.88 Median $24.55 Typical High $93.33 | Facility | 55 · Aftercare only | $12.88 | $24.55 | $93.33 |
Moda Health Setting Facility Modifier 56 · Pre-op care only Typical Low $8.71 Median $16.60 Typical High $61.66 | Facility | 56 · Pre-op care only | $8.71 | $16.60 | $61.66 |
Moda Health Setting Facility Modifier 59 · Distinct service Typical Low $66.07 Median $323.59 Typical High $446.68 | Facility | 59 · Distinct service | $66.07 | $323.59 | $446.68 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $36.31 Typical High $54.95 | Professional | 52 · Reduced service | $34.67 | $36.31 | $54.95 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $22.39 | Professional | 53 · Discontinued | $13.80 | $14.45 | $22.39 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $53.70 Typical High $83.18 | Professional | 54 · Surgery only | $51.29 | $53.70 | $83.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.72 Typical High $16.60 | Professional | 55 · Aftercare only | $10.23 | $10.72 | $16.60 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $11.22 |
Where Texas sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 18th of 51
$110
AK $224GA $45.71
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.