How much rates vary
Facilitymedian $437 · 10th to 90th $219 to $2,512Professionalmedian $245 · 10th to 90th $49 to $1,950
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 $707.95 Median $2,691.53 Typical High $6,918.31 | Facility | None | $707.95 | $2,691.53 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $363.08 | Professional | None | $134.90 | $257.04 | $363.08 |
BCBS Texas Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $1,445.44 | Facility | None | $229.09 | $436.52 | $1,445.44 |
BCBS Texas Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $426.58 | Professional | None | $128.82 | $245.47 | $426.58 |
Christus Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $1,862.09 | Facility | None | $213.80 | $309.03 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $380.19 | Professional | None | $138.04 | $251.19 | $380.19 |
Health Smart Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Lucent Health Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,949.84 | $1,949.84 | $2,344.23 |
Moda Health Setting Facility Modifier None Typical Low $173.78 Median $1,148.15 Typical High $4,786.30 | Facility | None | $173.78 | $1,148.15 | $4,786.30 |
Moda Health Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $363.08 | Professional | None | $134.90 | $257.04 | $363.08 |
Molina Setting Professional Modifier None Typical Low $38.90 Median $213.80 Typical High $288.40 | Professional | None | $38.90 | $213.80 | $288.40 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $426.58 Typical High $4,466.84 | Facility | None | $218.78 | $426.58 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $380.19 | Professional | None | $138.04 | $251.19 | $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 $117.49 Median $208.93 Typical High $354.81 | Professional | None | $117.49 | $208.93 | $354.81 |
Wellpoint Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $67.61 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $67.61 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $26.92 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $100.00 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $19.95 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.49 | $23.99 | $31.62 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $67.61 | $120.23 | $158.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $26.92 | $47.86 | $63.10 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $100.00 | $181.97 | $239.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $19.95 | $36.31 | $47.86 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.49 | $23.99 | $31.62 |
Where Texas sits
The same service costs 3.2 times more in Wisconsin 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· 33rd of 51
$269
WI $646KY $204
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.