How much rates vary
Facilitymedian $1,820 · 10th to 90th $195 to $4,786Professionalmedian $501 · 10th to 90th $95 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 $707.95 Median $2,570.40 Typical High $6,918.31 | Facility | None | $707.95 | $2,570.40 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $524.81 Typical High $758.58 | Professional | None | $123.03 | $524.81 | $758.58 |
BCBS Texas Setting Facility Modifier None Typical Low $2,041.74 Median $2,951.21 Typical High $4,677.35 | Facility | None | $2,041.74 | $2,951.21 | $4,677.35 |
BCBS Texas Setting Professional Modifier None Typical Low $114.82 Median $467.74 Typical High $794.33 | Professional | None | $114.82 | $467.74 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $776.25 | Professional | None | $138.04 | $338.84 | $776.25 |
Lucent Health Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,677.35 | Professional | None | $3,801.89 | $3,801.89 | $4,677.35 |
Moda Health Setting Facility Modifier None Typical Low $223.87 Median $1,862.09 Typical High $5,495.41 | Facility | None | $223.87 | $1,862.09 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $123.03 Median $524.81 Typical High $741.31 | Professional | None | $123.03 | $524.81 | $741.31 |
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 $125.89 Median $524.81 Typical High $954.99 | Facility | None | $125.89 | $524.81 | $954.99 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $776.25 | Professional | None | $138.04 | $338.84 | $776.25 |
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 $114.82 Median $380.19 Typical High $758.58 | Professional | None | $114.82 | $380.19 | $758.58 |
Wellpoint Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $61.66 Median $208.93 Typical High $354.81 | Professional | 52 · Reduced service | $61.66 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $83.18 Typical High $141.25 | Professional | 53 · Discontinued | $24.55 | $83.18 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $309.03 Typical High $524.81 | Professional | 54 · Surgery only | $91.20 | $309.03 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $61.66 Typical High $104.71 | Professional | 55 · Aftercare only | $18.20 | $61.66 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $41.69 Typical High $70.79 | Professional | 56 · Pre-op care only | $12.30 | $41.69 | $70.79 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $239.88 Typical High $354.81 | Professional | 52 · Reduced service | $61.66 | $239.88 | $354.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $95.50 Typical High $141.25 | Professional | 53 · Discontinued | $24.55 | $95.50 | $141.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $354.81 Typical High $537.03 | Professional | 54 · Surgery only | $91.20 | $354.81 | $537.03 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $74.13 Typical High $107.15 | Professional | 55 · Aftercare only | $18.20 | $74.13 | $107.15 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $50.12 Typical High $70.79 | Professional | 56 · Pre-op care only | $12.30 | $50.12 | $70.79 |
Where Texas sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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
$513
WI $851MD $214
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.