How much rates vary
Facilitymedian $309 · 10th to 90th $141 to $3,311Professionalmedian $269 · 10th to 90th $51 to $2,239
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 $275.42 Median $3,715.35 Typical High $9,120.11 | Facility | None | $275.42 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $309.03 | Professional | None | $147.91 | $245.47 | $309.03 |
BCBS Texas Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $602.56 | Professional | None | $173.78 | $295.12 | $602.56 |
Christus Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $186.21 Typical High $269.15 | Facility | None | $66.07 | $186.21 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $389.05 | Professional | None | $194.98 | $269.15 | $389.05 |
Lucent Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,238.72 | $2,238.72 | $2,951.21 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $707.95 Typical High $5,248.07 | Facility | None | $173.78 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $309.03 | Professional | None | $147.91 | $245.47 | $309.03 |
Molina Setting Professional Modifier None Typical Low $43.65 Median $245.47 Typical High $331.13 | Professional | None | $43.65 | $245.47 | $331.13 |
Providence Setting Facility Modifier None Typical Low $66.07 Median $199.53 Typical High $371.54 | Facility | None | $66.07 | $199.53 | $371.54 |
Providence Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $389.05 | Professional | None | $194.98 | $269.15 | $389.05 |
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 $223.87 Typical High $346.74 | Professional | None | $144.54 | $223.87 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
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 $74.13 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $74.13 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $29.51 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $112.20 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $37.15 Typical High $46.77 | Professional | 55 · Aftercare only | $22.39 | $37.15 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $14.79 | $24.55 | $30.90 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $74.13 | $123.03 | $147.91 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $29.51 | $48.98 | $58.88 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $112.20 | $181.97 | $218.78 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $37.15 Typical High $43.65 | Professional | 55 · Aftercare only | $22.39 | $37.15 | $43.65 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $14.79 | $24.55 | $29.51 |
Where Texas sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 32nd of 51
$269
AK $741KY $186
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.