How much rates vary
Facilitymedian $1,148 · 10th to 90th $151 to $3,802Professionalmedian $275 · 10th to 90th $155 to $1,698
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 $141.25 Median $165.96 Typical High $1,096.48 | Professional | None | $141.25 | $165.96 | $1,096.48 |
BCBS Texas Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $138.04 | Professional | None | $19.05 | $19.05 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $380.19 | Professional | None | $186.21 | $223.87 | $380.19 |
Lucent Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,288.25 | $1,698.24 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $1,778.28 Typical High $5,495.41 | Facility | None | $173.78 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $190.55 | Professional | None | $141.25 | $165.96 | $190.55 |
Molina Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $117.49 | Professional | None | $56.23 | $64.57 | $117.49 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $645.65 Typical High $2,691.53 | Facility | None | $69.18 | $645.65 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $380.19 | Professional | None | $186.21 | $223.87 | $380.19 |
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 $144.54 Median $251.19 Typical High $407.38 | Professional | None | $144.54 | $251.19 | $407.38 |
Wellpoint Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $70.79 Median $83.18 Typical High $93.33 | Professional | 52 · Reduced service | $70.79 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $37.15 | Professional | 53 · Discontinued | $28.18 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $141.25 | Professional | 54 · Surgery only | $104.71 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $28.18 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.60 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.13 | $16.60 | $18.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $83.18 Typical High $91.20 | Professional | 52 · Reduced service | $70.79 | $83.18 | $91.20 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $36.31 | Professional | 53 · Discontinued | $28.18 | $33.11 | $36.31 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | 54 · Surgery only | $104.71 | $123.03 | $138.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $27.54 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $27.54 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.60 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.13 | $16.60 | $18.20 |
Where Texas sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 11th of 51
$380
OK $1,000VA $138
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.