How much rates vary
Facilitymedian $1,259 · 10th to 90th $151 to $4,074Professionalmedian $95 · 10th to 90th $19 to $178
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 $707.95 Median $2,398.83 Typical High $6,918.31 | Facility | None | $707.95 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $21.88 | Professional | None | $19.50 | $21.38 | $21.88 |
BCBS Texas Setting Facility Modifier None Typical Low $44.67 Median $123.03 Typical High $190.55 | Facility | None | $44.67 | $123.03 | $190.55 |
BCBS Texas Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | None | $123.03 | $144.54 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $138.04 Typical High $181.97 | Facility | None | $128.82 | $138.04 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Lucent Health Setting Professional Modifier None Typical Low $95.50 Median $177.83 Typical High $177.83 | Professional | None | $95.50 | $177.83 | $177.83 |
Moda Health Setting Facility Modifier None Typical Low $630.96 Median $2,398.83 Typical High $6,456.54 | Facility | None | $630.96 | $2,398.83 | $6,456.54 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $309.03 Typical High $4,677.35 | Professional | None | $125.89 | $309.03 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Providence Setting Facility Modifier None Typical Low $18.20 Median $28.18 Typical High $138.04 | Facility | None | $18.20 | $28.18 | $138.04 |
Providence Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $16.60 Median $21.88 Typical High $33.11 | Professional | None | $16.60 | $21.88 | $33.11 |
Wellpoint Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $9.77 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $9.77 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.98 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $15.85 Typical High $15.85 | Professional | 54 · Surgery only | $14.79 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $2.95 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.95 | $2.09 | $2.09 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $95.50 | $95.50 | $95.50 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $19.05 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where Texas sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 16th of 51
$95.50
NH $269NJ $18.62
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.