How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,122 to $15,488Professionalmedian $2,570 · 10th to 90th $331 to $3,162
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 $1,000.00 Median $3,630.78 Typical High $9,120.11 | Facility | None | $1,000.00 | $3,630.78 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $4,168.69 | Professional | None | $331.13 | $346.74 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Christus Setting Facility Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Facility | None | $9,332.54 | $9,332.54 | $9,332.54 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $8,709.64 Typical High $12,302.69 | Facility | None | $758.58 | $8,709.64 | $12,302.69 |
Lucent Health Setting Professional Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,570.40 | $3,162.28 | $3,162.28 |
Moda Health Setting Facility Modifier None Typical Low $346.74 Median $3,019.95 Typical High $6,918.31 | Facility | None | $346.74 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $371.54 | Professional | None | $331.13 | $346.74 | $371.54 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $8,511.38 Typical High $12,302.69 | Facility | None | $489.78 | $8,511.38 | $12,302.69 |
Providence Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $9,772.37 Typical High $20,892.96 | Facility | None | $3,981.07 | $9,772.37 | $20,892.96 |
United Setting Professional Modifier None Typical Low $257.04 Median $371.54 Typical High $562.34 | Professional | None | $257.04 | $371.54 | $562.34 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $165.96 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $165.96 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $70.79 | Professional | 53 · Discontinued | $66.07 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $35.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $169.82 Typical High $177.83 | Professional | 52 · Reduced service | $165.96 | $169.82 | $177.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $70.79 | Professional | 53 · Discontinued | $66.07 | $69.18 | $70.79 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | 54 · Surgery only | $245.47 | $257.04 | $269.15 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $53.70 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $34.67 Typical High $35.48 | Professional | 56 · Pre-op care only | $33.11 | $34.67 | $35.48 |
Where Texas sits
The same service costs 15.8 times more in Arkansas than in Maine. 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· 8th of 51
$3,162
AR $6,918ME $437
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.