How much rates vary
Facilitymedian $162 · 10th to 90th $69 to $3,090Professionalmedian $91 · 10th to 90th $17 to $741
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 $93.33 Median $3,715.35 Typical High $9,120.11 | Facility | None | $93.33 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $100.00 | Professional | None | $57.54 | $83.18 | $100.00 |
BCBS Texas Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $549.54 | Facility | None | $60.26 | $102.33 | $549.54 |
BCBS Texas Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $245.47 | Professional | None | $67.61 | $107.15 | $245.47 |
Christus Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $97.72 Typical High $151.36 | Facility | None | $66.07 | $97.72 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $131.83 | Professional | None | $70.79 | $97.72 | $131.83 |
Lucent Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,000.00 | Professional | None | $741.31 | $741.31 | $1,000.00 |
Moda Health Setting Facility Modifier None Typical Low $64.57 Median $707.95 Typical High $5,248.07 | Facility | None | $64.57 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $104.71 | Professional | None | $57.54 | $83.18 | $104.71 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $83.18 Typical High $109.65 | Professional | None | $14.79 | $83.18 | $109.65 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $100.00 Typical High $147.91 | Facility | None | $64.57 | $100.00 | $147.91 |
Providence Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $134.90 | Professional | None | $69.18 | $97.72 | $134.90 |
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 $54.95 Median $81.28 Typical High $123.03 | Professional | None | $54.95 | $81.28 | $123.03 |
Wellpoint Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
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 $28.84 Median $41.69 Typical High $52.48 | Professional | 52 · Reduced service | $28.84 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $20.89 | Professional | 53 · Discontinued | $11.48 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $61.66 Typical High $77.62 | Professional | 54 · Surgery only | $43.65 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $15.85 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $10.47 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $41.69 | $50.12 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $11.48 | $16.60 | $19.95 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $61.66 Typical High $74.13 | Professional | 54 · Surgery only | $43.65 | $61.66 | $74.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $15.14 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $10.00 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 38th of 51
$93.33
AK $282FL $74.13
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.