How much rates vary
Facilitymedian $871 · 10th to 90th $105 to $6,166Professionalmedian $83 · 10th to 90th $14 to $646
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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $891.25 | Professional | None | $77.62 | $83.18 | $891.25 |
BCBS Texas Setting Facility Modifier None Typical Low $87.10 Median $158.49 Typical High $1,122.02 | Facility | None | $87.10 | $158.49 | $1,122.02 |
BCBS Texas Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $165.96 | Professional | None | $70.79 | $95.50 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,258.93 Typical High $2,691.53 | Facility | None | $616.60 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $154.88 | Professional | None | $77.62 | $89.13 | $154.88 |
Lucent Health Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Moda Health Setting Facility Modifier None Typical Low $91.20 Median $1,584.89 Typical High $5,128.61 | Facility | None | $91.20 | $1,584.89 | $5,128.61 |
Moda Health Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $117.49 | Professional | None | $77.62 | $83.18 | $117.49 |
Molina Setting Professional Modifier None Typical Low $10.00 Median $56.23 Typical High $74.13 | Professional | None | $10.00 | $56.23 | $74.13 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $1,318.26 Typical High $251,188.64 | Facility | None | $131.83 | $1,318.26 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $158.49 | Professional | None | $77.62 | $89.13 | $158.49 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $138.04 | Professional | None | $66.07 | $89.13 | $138.04 |
Wellpoint Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $38.02 Median $41.69 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $15.14 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $63.10 Typical High $69.18 | Professional | 54 · Surgery only | $57.54 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $12.59 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $8.32 | $9.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $41.69 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $41.69 | $45.71 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $15.14 | $16.98 | $18.20 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $63.10 Typical High $69.18 | Professional | 54 · Surgery only | $57.54 | $63.10 | $69.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $12.59 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $12.59 | $13.80 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $8.32 | $9.12 |
Where Texas sits
The same service costs 6.5 times more in Tennessee than in New York. 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· 43rd of 51
$110
TN $513NY $79.43
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.