How much rates vary
Facilitymedian $832 · 10th to 90th $16 to $6,918Professionalmedian $19 · 10th to 90th $14 to $34
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 $16.22 Median $3,715.35 Typical High $9,120.11 | Facility | None | $16.22 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $25.70 | Professional | None | $12.30 | $16.22 | $25.70 |
BCBS Texas Setting Facility Modifier None Typical Low $5.75 Median $4,365.16 Typical High $19,498.45 | Facility | None | $5.75 | $4,365.16 | $19,498.45 |
BCBS Texas Setting Professional Modifier None Typical Low $14.45 Median $19.05 Typical High $28.84 | Professional | None | $14.45 | $19.05 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $1,995.26 Typical High $2,691.53 | Facility | None | $50.12 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $25.70 | Professional | None | $15.14 | $18.62 | $25.70 |
Lucent Health Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Moda Health Setting Facility Modifier None Typical Low $14.45 Median $645.65 Typical High $5,248.07 | Facility | None | $14.45 | $645.65 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $12.30 Median $16.22 Typical High $25.70 | Professional | None | $12.30 | $16.22 | $25.70 |
Molina Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $15.49 | Professional | None | $12.30 | $13.49 | $15.49 |
Providence Setting Facility Modifier None Typical Low $13.49 Median $33.88 Typical High $2,691.53 | Facility | None | $13.49 | $33.88 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $25.70 | Professional | None | $15.14 | $18.62 | $25.70 |
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 $13.49 Median $18.62 Typical High $24.55 | Professional | None | $13.49 | $18.62 | $24.55 |
Wellpoint Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
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 $6.17 Median $7.24 Typical High $8.71 | Professional | 52 · Reduced service | $6.17 | $7.24 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.88 Typical High $3.55 | Professional | 53 · Discontinued | $2.45 | $2.88 | $3.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $10.96 Typical High $13.18 | Professional | 54 · Surgery only | $9.12 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.19 Typical High $2.63 | Professional | 55 · Aftercare only | $1.82 | $2.19 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.45 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.23 | $1.45 | $1.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $7.24 Typical High $8.71 | Professional | 52 · Reduced service | $6.17 | $7.24 | $8.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.88 Typical High $3.55 | Professional | 53 · Discontinued | $2.45 | $2.88 | $3.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $10.96 Typical High $13.18 | Professional | 54 · Surgery only | $9.12 | $10.96 | $13.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.19 Typical High $2.63 | Professional | 55 · Aftercare only | $1.82 | $2.19 | $2.63 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.45 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.23 | $1.45 | $1.78 |
Where Texas sits
The same service costs 3.9 times more in Alaska 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· 34th of 51
$19.50
AK $64.57NJ $16.60
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.