How much rates vary
Facilitymedian $4,571 · 10th to 90th $871 to $9,550Professionalmedian $490 · 10th to 90th $78 to $3,388
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 $977.24 Median $3,311.31 Typical High $9,120.11 | Facility | None | $977.24 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $1,995.26 | Professional | None | $446.68 | $489.78 | $1,995.26 |
BCBS Texas Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $1,023.29 | Professional | None | $426.58 | $549.54 | $1,023.29 |
Christus Setting Facility Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Facility | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $8,317.64 | Facility | None | $758.58 | $5,888.44 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $831.76 | Professional | None | $467.74 | $602.56 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,890.45 | Professional | None | $3,388.44 | $3,388.44 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $524.81 Median $2,290.87 Typical High $6,025.60 | Facility | None | $524.81 | $2,290.87 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $724.44 | Professional | None | $446.68 | $489.78 | $724.44 |
Molina Setting Professional Modifier None Typical Low $69.18 Median $380.19 Typical High $512.86 | Professional | None | $69.18 | $380.19 | $512.86 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $5,754.40 Typical High $8,128.31 | Facility | None | $562.34 | $5,754.40 | $8,128.31 |
Providence Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $831.76 | Professional | None | $467.74 | $602.56 | $831.76 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $776.25 | Professional | None | $380.19 | $512.86 | $776.25 |
Wellpoint Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $223.87 Median $245.47 Typical High $275.42 | Professional | 52 · Reduced service | $223.87 | $245.47 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $109.65 | Professional | 53 · Discontinued | $89.13 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $331.13 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $54.95 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $245.47 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $245.47 | $269.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $97.72 Typical High $107.15 | Professional | 53 · Discontinued | $89.13 | $97.72 | $107.15 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $363.08 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $363.08 | $407.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $72.44 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $72.44 | $81.28 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $48.98 Typical High $53.70 | Professional | 56 · Pre-op care only | $44.67 | $48.98 | $53.70 |
Where Texas sits
The same service costs 3.9 times more in Alaska 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· 49th of 51
$537
AK $1,905NY $490
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.