How much rates vary
Facilitymedian $813 · 10th to 90th $33 to $3,802Professionalmedian $28 · 10th to 90th $6 to $85
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 $27.54 Median $3,715.35 Typical High $9,120.11 | Facility | None | $27.54 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $23.99 Typical High $30.90 | Professional | None | $13.18 | $23.99 | $30.90 |
BCBS Texas Setting Professional Modifier None Typical Low $15.49 Median $26.92 Typical High $66.07 | Professional | None | $15.49 | $26.92 | $66.07 |
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 $16.22 Median $28.18 Typical High $54.95 | Professional | None | $16.22 | $28.18 | $54.95 |
Lucent Health Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | None | $302.00 | $309.03 | $309.03 |
Moda Health Setting Facility Modifier None Typical Low $14.79 Median $707.95 Typical High $5,248.07 | Facility | None | $14.79 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $13.18 Median $23.99 Typical High $31.62 | Professional | None | $13.18 | $23.99 | $31.62 |
Molina Setting Professional Modifier None Typical Low $4.79 Median $26.30 Typical High $36.31 | Professional | None | $4.79 | $26.30 | $36.31 |
Providence Setting Facility Modifier None Typical Low $14.45 Median $50.12 Typical High $2,691.53 | Facility | None | $14.45 | $50.12 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $54.95 | Professional | None | $16.22 | $28.18 | $54.95 |
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 $14.45 Median $28.84 Typical High $54.95 | Professional | None | $14.45 | $28.84 | $54.95 |
Wellpoint Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
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 $6.46 Median $11.75 Typical High $14.79 | Professional | 52 · Reduced service | $6.46 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $4.68 Typical High $5.89 | Professional | 53 · Discontinued | $2.63 | $4.68 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $17.78 Typical High $22.39 | Professional | 54 · Surgery only | $9.77 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $3.55 Typical High $4.47 | Professional | 55 · Aftercare only | $1.95 | $3.55 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.29 | $2.34 | $2.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $6.46 Median $11.75 Typical High $14.79 | Professional | 52 · Reduced service | $6.46 | $11.75 | $14.79 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $4.68 Typical High $5.89 | Professional | 53 · Discontinued | $2.63 | $4.68 | $5.89 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $9.77 Median $17.38 Typical High $22.39 | Professional | 54 · Surgery only | $9.77 | $17.38 | $22.39 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $3.47 Typical High $4.47 | Professional | 55 · Aftercare only | $1.95 | $3.47 | $4.47 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $2.34 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.29 | $2.34 | $2.95 |
Where Texas sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 45th of 51
$28.84
AK $85.11HI $21.88
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.