How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,096 to $7,762Professionalmedian $1,778 · 10th to 90th $214 to $2,188
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 $229.09 Median $239.88 Typical High $4,168.69 | Professional | None | $229.09 | $239.88 | $4,168.69 |
BCBS Texas Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Christus Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,570.40 Typical High $3,467.37 | Facility | None | $758.58 | $2,570.40 | $3,467.37 |
Lucent Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,778.28 | $2,187.76 | $2,187.76 |
Moda Health Setting Facility Modifier None Typical Low $239.88 Median $3,019.95 Typical High $6,918.31 | Facility | None | $239.88 | $3,019.95 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $257.04 | Professional | None | $229.09 | $239.88 | $257.04 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $2,570.40 Typical High $3,467.37 | Facility | None | $478.63 | $2,570.40 | $3,467.37 |
Providence Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $9,549.93 | Facility | None | $1,698.24 | $4,570.88 | $9,549.93 |
United Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $398.11 | Professional | None | $181.97 | $263.03 | $398.11 |
Wellpoint Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
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 $114.82 Median $120.23 Typical High $125.89 | Professional | 52 · Reduced service | $114.82 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | 53 · Discontinued | $45.71 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $186.21 | Professional | 54 · Surgery only | $173.78 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $37.15 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $25.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $120.23 Typical High $125.89 | Professional | 52 · Reduced service | $114.82 | $120.23 | $125.89 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $50.12 | Professional | 53 · Discontinued | $45.71 | $47.86 | $50.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $186.21 | Professional | 54 · Surgery only | $173.78 | $177.83 | $186.21 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $37.15 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $37.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $25.12 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $25.12 |
Where Texas sits
The same service costs 10.7 times more in Colorado 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· 3rd of 51
$2,042
CO $2,512ME $234
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.