How much rates vary
Facilitymedian $3,548 · 10th to 90th $78 to $7,943Professionalmedian $174 · 10th to 90th $60 to $631
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None (both parts) Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $28.84 Typical High $29.51 | Professional | 26 · Professional part | $27.54 | $28.84 | $29.51 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $47.86 Typical High $48.98 | Professional | TC · Technical part | $43.65 | $47.86 | $48.98 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $173.78 Median $436.52 Typical High $436.52 | Professional | None (both parts) | $173.78 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $37.15 Typical High $42.66 | Facility | None | $33.11 | $37.15 | $42.66 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | None (both parts) | $537.03 | $630.96 | $630.96 |
Lucent Health Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 26 · Professional part | $208.93 | $229.09 | $229.09 |
Lucent Health Setting Professional Modifier TC · Technical part Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | TC · Technical part | $323.59 | $407.38 | $407.38 |
Moda Health Setting Facility Modifier None Typical Low $77.62 Median $2,511.89 Typical High $6,918.31 | Facility | None | $77.62 | $2,511.89 | $6,918.31 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | None (both parts) | $72.44 | $77.62 | $77.62 |
Moda Health Setting Professional Modifier 26 · Professional part Typical Low $28.18 Median $28.84 Typical High $29.51 | Professional | 26 · Professional part | $28.18 | $28.84 | $29.51 |
Moda Health Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $47.86 Typical High $48.98 | Professional | TC · Technical part | $44.67 | $47.86 | $48.98 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $77.62 Typical High $109.65 | Facility | None | $33.11 | $77.62 | $109.65 |
Providence Setting Professional Modifier None (both parts) Typical Low $47.86 Median $64.57 Typical High $125.89 | Professional | None (both parts) | $47.86 | $64.57 | $125.89 |
United Setting Facility Modifier None Typical Low $56.23 Median $58.88 Typical High $77.62 | Facility | None | $56.23 | $58.88 | $77.62 |
United Setting Professional Modifier None (both parts) Typical Low $60.26 Median $79.43 Typical High $117.49 | Professional | None (both parts) | $60.26 | $79.43 | $117.49 |
United Setting Professional Modifier 26 · Professional part Typical Low $22.91 Median $30.20 Typical High $44.67 | Professional | 26 · Professional part | $22.91 | $30.20 | $44.67 |
United Setting Professional Modifier TC · Technical part Typical Low $37.15 Median $48.98 Typical High $72.44 | Professional | TC · Technical part | $37.15 | $48.98 | $72.44 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None (both parts) | $58.88 | $58.88 | $58.88 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 26 · Professional part | $33.88 | $33.88 | $33.88 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | TC · Technical part | $44.67 | $44.67 | $44.67 |
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 $35.48 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $35.48 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.49 Typical High $15.85 | Professional | 53 · Discontinued | $14.13 | $15.49 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $57.54 Typical High $58.88 | Professional | 54 · Surgery only | $53.70 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.48 Typical High $11.75 | Professional | 55 · Aftercare only | $10.72 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.08 | $7.76 | $7.76 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $36.31 | $38.90 | $38.90 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.49 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $15.49 | $15.85 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $57.54 Typical High $58.88 | Professional | 54 · Surgery only | $54.95 | $57.54 | $58.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $11.75 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $7.24 | $7.76 | $7.76 |
Where Texas sits
The same service costs 4.4 times more in Texas than in New York. 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
$174
TX $174NY $39.81
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.