How much rates vary
Facilitymedian $3,388 · 10th to 90th $759 to $6,166Professionalmedian $398 · 10th to 90th $62 to $3,236
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 $724.44 Median $3,715.35 Typical High $9,120.11 | Facility | None | $724.44 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $588.84 | Professional | None | $416.87 | $467.74 | $588.84 |
BCBS Texas Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $724.44 | Professional | None | $407.38 | $512.86 | $724.44 |
Christus Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,467.37 Typical High $4,897.79 | Facility | None | $758.58 | $3,467.37 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $630.96 | Professional | None | $371.54 | $478.63 | $630.96 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Moda Health Setting Facility Modifier None Typical Low $371.54 Median $1,778.28 Typical High $6,025.60 | Facility | None | $371.54 | $1,778.28 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $602.56 | Professional | None | $416.87 | $467.74 | $602.56 |
Molina Setting Professional Modifier None Typical Low $54.95 Median $302.00 Typical High $398.11 | Professional | None | $54.95 | $302.00 | $398.11 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $3,388.44 Typical High $4,897.79 | Facility | None | $489.78 | $3,388.44 | $4,897.79 |
Providence Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $660.69 | Professional | None | $363.08 | $478.63 | $660.69 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,918.31 | Facility | None | $1,258.93 | $3,311.31 | $6,918.31 |
United Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $660.69 | Professional | None | $234.42 | $371.54 | $660.69 |
Wellpoint Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $213.80 Median $234.42 Typical High $263.03 | Professional | 52 · Reduced service | $213.80 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $104.71 | Professional | 53 · Discontinued | $85.11 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $70.79 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $52.48 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $213.80 | $234.42 | $257.04 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $93.33 | $102.33 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $354.81 | $380.19 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $70.79 | $77.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $42.66 | $46.77 | $51.29 |
Where Texas sits
The same service costs 5.2 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· 48th of 51
$427
AK $1,820KY $347
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.