How much rates vary
Facilitymedian $2,138 · 10th to 90th $724 to $5,495Professionalmedian $4,898 · 10th to 90th $1,950 to $22,909
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 $812.83 Median $2,454.71 Typical High $6,918.31 | Facility | None | $812.83 | $2,454.71 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,467.37 Typical High $3,630.78 | Professional | None | $3,019.95 | $3,467.37 | $3,630.78 |
BCBS Texas Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $6,025.60 | Facility | None | $1,445.44 | $2,630.27 | $6,025.60 |
BCBS Texas Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Christus Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $977.24 Typical High $3,981.07 | Facility | None | $691.83 | $977.24 | $3,981.07 |
Lucent Health Setting Professional Modifier None Typical Low $21,877.62 Median $22,908.68 Typical High $22,908.68 | Professional | None | $21,877.62 | $22,908.68 | $22,908.68 |
Moda Health Setting Facility Modifier None Typical Low $467.74 Median $2,454.71 Typical High $5,495.41 | Facility | None | $467.74 | $2,454.71 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,467.37 Typical High $3,630.78 | Professional | None | $3,388.44 | $3,467.37 | $3,630.78 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $9,772.37 | Facility | None | $691.83 | $1,122.02 | $9,772.37 |
Providence Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $4,265.80 | Professional | None | $316.23 | $363.08 | $4,265.80 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,890.45 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,890.45 | $5,888.44 |
Wellpoint Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
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 $1,698.24 Median $1,737.80 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $724.44 | Professional | 53 · Discontinued | $676.08 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $549.54 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $363.08 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $363.08 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,698.24 Median $1,737.80 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,698.24 | $1,737.80 | $1,819.70 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $707.95 Typical High $724.44 | Professional | 53 · Discontinued | $676.08 | $707.95 | $724.44 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,630.27 Typical High $2,754.23 | Professional | 54 · Surgery only | $2,511.89 | $2,630.27 | $2,754.23 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $524.81 Typical High $549.54 | Professional | 55 · Aftercare only | $501.19 | $524.81 | $549.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $346.74 Typical High $363.08 | Professional | 56 · Pre-op care only | $338.84 | $346.74 | $363.08 |
Where Texas sits
The same service costs 3.5 times more in Indiana than in Maryland. 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· 23rd of 51
$3,388
IN $5,495MD $1,549
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.