How much rates vary
Facilitymedian $100 · 10th to 90th $100 to $214Professionalmedian $126 · 10th to 90th $43 to $1,096
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 $42.66 Median $43.65 Typical High $43.65 | Facility | None | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $44.67 | Professional | None | $42.66 | $43.65 | $44.67 |
BCBS Texas Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Christus Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $316.23 | Facility | None | $125.89 | $169.82 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,096.48 | Professional | None | $660.69 | $1,096.48 | $1,096.48 |
Moda Health Setting Facility Modifier None Typical Low $43.65 Median $53.70 Typical High $63.10 | Facility | None | $43.65 | $53.70 | $63.10 |
Moda Health Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $50.12 | Professional | None | $42.66 | $43.65 | $50.12 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $302.00 | Professional | None | $204.17 | $204.17 | $302.00 |
Providence Setting Facility Modifier None Typical Low $63.10 Median $169.82 Typical High $302.00 | Facility | None | $63.10 | $169.82 | $302.00 |
Providence Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Wellpoint Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $21.38 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.91 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $31.62 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $4.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.88 | $21.88 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.71 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $33.11 Typical High $33.11 | Professional | 54 · Surgery only | $31.62 | $33.11 | $33.11 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $4.37 |
Where Texas sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 27th of 51
$126
ND $182HI $28.84
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.