How much rates vary
Facilitymedian $5,248 · 10th to 90th $724 to $18,621Professionalmedian $589 · 10th to 90th $245 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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | None | $245.47 | $257.04 | $269.15 |
BCBS Texas Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Christus Setting Facility Modifier None Typical Low $15,135.61 Median $15,135.61 Typical High $15,135.61 | Facility | None | $15,135.61 | $15,135.61 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $15,488.17 Typical High $22,387.21 | Facility | None | $758.58 | $15,488.17 | $22,387.21 |
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 $263.03 Median $1,819.70 Typical High $5,495.41 | Facility | None | $263.03 | $1,819.70 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $269.15 | Professional | None | $245.47 | $257.04 | $269.15 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $15,135.61 Typical High $22,387.21 | Facility | None | $275.42 | $15,135.61 | $22,387.21 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,165.95 Typical High $15,848.93 | Facility | None | $2,630.27 | $6,165.95 | $15,848.93 |
United Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $407.38 | Professional | None | $204.17 | $269.15 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $123.03 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $123.03 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $199.53 | Professional | 54 · Surgery only | $186.21 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $26.92 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $128.82 Typical High $131.83 | Professional | 52 · Reduced service | $123.03 | $128.82 | $131.83 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $51.29 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $51.29 | $53.70 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $199.53 | Professional | 54 · Surgery only | $186.21 | $190.55 | $199.53 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $39.81 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $39.81 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.70 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $25.70 | $26.92 |
Where Texas sits
The same service costs 9.5 times more in Arkansas than in Kentucky. 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· 2nd of 51
$1,778
AR $1,905KY $200
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.