How much rates vary
Facilitymedian $1,660 · 10th to 90th $195 to $4,571Professionalmedian $501 · 10th to 90th $95 to $3,715
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 $645.65 Median $2,238.72 Typical High $6,918.31 | Facility | None | $645.65 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $537.03 Typical High $724.44 | Professional | None | $147.91 | $537.03 | $724.44 |
BCBS Texas Setting Professional Modifier None Typical Low $120.23 Median $346.74 Typical High $660.69 | Professional | None | $120.23 | $346.74 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $338.84 Typical High $741.31 | Professional | None | $173.78 | $338.84 | $741.31 |
Lucent Health Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,466.84 | Professional | None | $3,715.35 | $3,715.35 | $4,466.84 |
Moda Health Setting Facility Modifier None Typical Low $281.84 Median $1,584.89 Typical High $5,248.07 | Facility | None | $281.84 | $1,584.89 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $147.91 Median $537.03 Typical High $724.44 | Professional | None | $147.91 | $537.03 | $724.44 |
Molina Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $575.44 | Professional | None | $79.43 | $457.09 | $575.44 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $489.78 Typical High $954.99 | Facility | None | $158.49 | $489.78 | $954.99 |
Providence Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $724.44 | Professional | None | $173.78 | $346.74 | $724.44 |
United Setting Facility Modifier None Typical Low $177.83 Median $1,348.96 Typical High $2,691.53 | Facility | None | $177.83 | $1,348.96 | $2,691.53 |
United Setting Professional Modifier None Typical Low $141.25 Median $371.54 Typical High $741.31 | Professional | None | $141.25 | $371.54 | $741.31 |
Wellpoint Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
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 $74.13 Median $213.80 Typical High $346.74 | Professional | 52 · Reduced service | $74.13 | $213.80 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $85.11 Typical High $138.04 | Professional | 53 · Discontinued | $29.51 | $85.11 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $316.23 Typical High $524.81 | Professional | 54 · Surgery only | $109.65 | $316.23 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $63.10 Typical High $104.71 | Professional | 55 · Aftercare only | $21.88 | $63.10 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $42.66 Typical High $69.18 | Professional | 56 · Pre-op care only | $14.79 | $42.66 | $69.18 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $74.13 Median $251.19 Typical High $346.74 | Professional | 52 · Reduced service | $74.13 | $251.19 | $346.74 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $100.00 Typical High $141.25 | Professional | 53 · Discontinued | $29.51 | $100.00 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $371.54 Typical High $524.81 | Professional | 54 · Surgery only | $109.65 | $371.54 | $524.81 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $75.86 Typical High $104.71 | Professional | 55 · Aftercare only | $21.88 | $75.86 | $104.71 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $50.12 Typical High $69.18 | Professional | 56 · Pre-op care only | $14.79 | $50.12 | $69.18 |
Where Texas sits
The same service costs 3.5 times more in Wisconsin than in Nebraska. 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· 24th of 51
$513
WI $912NE $257
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.