How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,445 to $8,913Professionalmedian $1,202 · 10th to 90th $468 to $4,467
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 $977.24 Median $3,311.31 Typical High $9,120.11 | Facility | None | $977.24 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $512.86 | Professional | None | $467.74 | $489.78 | $512.86 |
BCBS Texas Setting Facility Modifier None Typical Low $4,168.69 Median $6,309.57 Typical High $10,964.78 | Facility | None | $4,168.69 | $6,309.57 | $10,964.78 |
Christus Setting Facility Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Facility | None | $6,025.60 | $6,025.60 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,623.41 Typical High $8,128.31 | Facility | None | $758.58 | $5,623.41 | $8,128.31 |
Lucent Health Setting Professional Modifier None Typical Low $3,630.78 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,630.78 | $4,466.84 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $676.08 Median $3,090.30 Typical High $6,918.31 | Facility | None | $676.08 | $3,090.30 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $512.86 | Professional | None | $467.74 | $489.78 | $512.86 |
Providence Setting Facility Modifier None Typical Low $660.69 Median $5,888.44 Typical High $8,128.31 | Facility | None | $660.69 | $5,888.44 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $794.33 | Professional | None | $389.05 | $524.81 | $794.33 |
Wellpoint Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $234.42 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $51.29 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $245.47 Typical High $257.04 | Professional | 52 · Reduced service | $234.42 | $245.47 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | 53 · Discontinued | $93.33 | $97.72 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $354.81 | $363.08 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $74.13 Typical High $75.86 | Professional | 55 · Aftercare only | $70.79 | $74.13 | $75.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $46.77 | $48.98 | $51.29 |
Where Texas sits
The same service costs 7.2 times more in Texas than in Pennsylvania. 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· 1st of 51
$3,631
TX $3,631PA $501
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.