How much rates vary
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 $407.38 Median $446.68 Typical High $524.81 | Professional | None | $407.38 | $446.68 | $524.81 |
BCBS Texas Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $2,691.53 | Facility | None | $630.96 | $1,258.93 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $562.34 | Professional | None | $354.81 | $501.19 | $562.34 |
Lucent Health Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $7,244.36 | Professional | None | $6,760.83 | $6,760.83 | $7,244.36 |
Moda Health Setting Facility Modifier None Typical Low $512.86 Median $1,995.26 Typical High $6,918.31 | Facility | None | $512.86 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $524.81 | Professional | None | $407.38 | $446.68 | $524.81 |
Molina Setting Professional Modifier None Typical Low $61.66 Median $70.79 Typical High $446.68 | Professional | None | $61.66 | $70.79 | $446.68 |
Providence Setting Facility Modifier None Typical Low $562.34 Median $1,479.11 Typical High $251,188.64 | Facility | None | $562.34 | $1,479.11 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $562.34 | Professional | None | $354.81 | $501.19 | $562.34 |
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 $302.00 Median $416.87 Typical High $645.65 | Professional | None | $302.00 | $416.87 | $645.65 |
Wellpoint Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
6 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 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $48.98 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $331.13 Typical High $371.54 | Professional | 54 · Surgery only | $302.00 | $331.13 | $371.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $74.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $48.98 |
Where Texas sits
The same service costs 7.1 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· 4th of 51
$1,380
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.