How much rates vary
Facilitymedian $1,995 · 10th to 90th $389 to $6,918Professionalmedian $302 · 10th to 90th $41 to $14,791
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 $275.42 Median $309.03 Typical High $389.05 | Professional | None | $275.42 | $309.03 | $389.05 |
BCBS Texas Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $467.74 | Professional | None | $257.04 | $323.59 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,479.11 Typical High $2,691.53 | Facility | None | $537.03 | $1,479.11 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $501.19 | Professional | None | $263.03 | $354.81 | $501.19 |
Lucent Health Setting Professional Modifier None Typical Low $3,090.30 Median $14,791.08 Typical High $14,791.08 | Professional | None | $3,090.30 | $14,791.08 | $14,791.08 |
Moda Health Setting Facility Modifier None Typical Low $275.42 Median $1,819.70 Typical High $6,918.31 | Facility | None | $275.42 | $1,819.70 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $398.11 | Professional | None | $275.42 | $309.03 | $398.11 |
Molina Setting Professional Modifier None Typical Low $34.67 Median $190.55 Typical High $257.04 | Professional | None | $34.67 | $190.55 | $257.04 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $645.65 Typical High $2,691.53 | Facility | None | $275.42 | $645.65 | $2,691.53 |
Providence Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $501.19 | Professional | None | $263.03 | $354.81 | $501.19 |
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 $223.87 Median $316.23 Typical High $489.78 | Professional | None | $223.87 | $316.23 | $489.78 |
Wellpoint Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $138.04 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $54.95 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $34.67 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $151.36 | $173.78 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $61.66 Typical High $69.18 | Professional | 53 · Discontinued | $54.95 | $61.66 | $69.18 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 54 · Surgery only | $204.17 | $229.09 | $257.04 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $40.74 | $45.71 | $52.48 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $30.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $27.54 | $30.20 | $34.67 |
Where Texas sits
The same service costs 3.9 times more in Wisconsin 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· 47th of 51
$347
WI $1,175NY $302
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.