How much rates vary
Facilitymedian $2,138 · 10th to 90th $490 to $10,471Professionalmedian $2,399 · 10th to 90th $1,738 to $14,125
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 $1,122.02 Median $3,715.35 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,949.84 | $2,290.87 |
BCBS Texas Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,548.82 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,548.82 | $2,238.72 | $2,511.89 |
Lucent Health Setting Professional Modifier None Typical Low $12,882.50 Median $14,125.38 Typical High $14,125.38 | Professional | None | $12,882.50 | $14,125.38 | $14,125.38 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $2,754.23 Typical High $6,918.31 | Facility | None | $977.24 | $2,754.23 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,778.28 | $1,949.84 | $2,290.87 |
Molina Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,659.59 | $1,737.80 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,398.83 Typical High $251,188.64 | Facility | None | $758.58 | $2,398.83 | $251,188.64 |
Providence Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $2,511.89 | Professional | None | $1,548.82 | $2,238.72 | $2,511.89 |
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 $1,230.27 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,819.70 | $2,691.53 |
Wellpoint Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $891.25 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $354.81 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $213.80 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,071.52 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $354.81 | $389.05 | $436.52 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,445.44 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,445.44 | $1,621.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $288.40 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $288.40 | $323.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $213.80 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $213.80 |
Where Texas sits
The same service costs 5.5 times more in Wisconsin than in South Carolina. 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· 23rd of 51
$2,344
WI $7,586SC $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.