How much rates vary
Facilitymedian $1,905 · 10th to 90th $457 to $10,471Professionalmedian $513 · 10th to 90th $76 to $3,802
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 $457.09 Median $512.86 Typical High $645.65 | Professional | None | $457.09 | $512.86 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
BCBS Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $741.31 | Professional | None | $416.87 | $524.81 | $741.31 |
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 $436.52 Median $588.84 Typical High $831.76 | Professional | None | $436.52 | $588.84 | $831.76 |
Lucent Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,235.94 | $3,801.89 | $3,801.89 |
Moda Health Setting Facility Modifier None Typical Low $457.09 Median $1,995.26 Typical High $6,918.31 | Facility | None | $457.09 | $1,995.26 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $645.65 | Professional | None | $457.09 | $512.86 | $645.65 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $346.74 Typical High $478.63 | Professional | None | $64.57 | $346.74 | $478.63 |
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 $436.52 Median $588.84 Typical High $831.76 | Professional | None | $436.52 | $588.84 | $831.76 |
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 $371.54 Median $549.54 Typical High $851.14 | Professional | None | $371.54 | $549.54 | $851.14 |
Wellpoint Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $229.09 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $57.54 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $251.19 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $251.19 | $288.40 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $102.33 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $102.33 | $114.82 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $380.19 | $436.52 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $75.86 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $75.86 | $87.10 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $51.29 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $51.29 | $57.54 |
Where Texas sits
The same service costs 4.0 times more in Wisconsin 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· 47th of 51
$550
WI $1,905KY $479
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.