How much rates vary
Facilitymedian $2,399 · 10th to 90th $513 to $12,589Professionalmedian $11,220 · 10th to 90th $1,585 to $13,490
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 $1,737.80 Median $4,466.84 Typical High $13,182.57 | Facility | None | $1,737.80 | $4,466.84 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $3,715.35 | Professional | None | $1,737.80 | $1,778.28 | $3,715.35 |
BCBS Texas Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $2,691.53 | Facility | None | $630.96 | $1,288.25 | $2,691.53 |
Lucent Health Setting Professional Modifier None Typical Low $11,220.18 Median $13,489.63 Typical High $13,489.63 | Professional | None | $11,220.18 | $13,489.63 | $13,489.63 |
Moda Health Setting Facility Modifier None Typical Low $1,096.48 Median $3,715.35 Typical High $14,791.08 | Facility | None | $1,096.48 | $3,715.35 | $14,791.08 |
Moda Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,737.80 | $1,778.28 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $1,778.28 Typical High $251,188.64 | Facility | None | $758.58 | $1,778.28 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,548.82 | $2,187.76 | $3,467.37 |
Wellpoint Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $851.14 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $346.74 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $186.21 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $933.25 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $346.74 | $354.81 | $371.54 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,412.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $281.84 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $186.21 |
Where Texas sits
The same service costs 5.8 times more in California than in Arkansas. 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· 9th of 51
$3,090
CA $6,918AR $1,202
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.