How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,349 to $70,795Professionalmedian $214 · 10th to 90th $34 to $100,000
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 $1,000.00 Median $3,801.89 Typical High $10,232.93 | Facility | None | $1,000.00 | $3,801.89 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $691.83 | Professional | None | $223.87 | $234.42 | $691.83 |
BCBS Texas Setting Facility Modifier None Typical Low $8,912.51 Median $61,659.50 Typical High $125,892.54 | Facility | None | $8,912.51 | $61,659.50 | $125,892.54 |
BCBS Texas Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $426.58 | Professional | None | $213.80 | $275.42 | $426.58 |
Christus Setting Facility Modifier None Typical Low $16,982.44 Median $16,982.44 Typical High $16,982.44 | Facility | None | $16,982.44 | $16,982.44 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
Lucent Health Setting Professional Modifier None Typical Low $3,467.37 Median $100,000.00 Typical High $100,000.00 | Professional | None | $3,467.37 | $100,000.00 | $100,000.00 |
Moda Health Setting Facility Modifier None Typical Low $204.17 Median $2,454.71 Typical High $6,918.31 | Facility | None | $204.17 | $2,454.71 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $331.13 | Professional | None | $223.87 | $234.42 | $331.13 |
Molina Setting Professional Modifier None Typical Low $29.51 Median $162.18 Typical High $218.78 | Professional | None | $29.51 | $162.18 | $218.78 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $204.17 Typical High $346.74 | Facility | None | $165.96 | $204.17 | $346.74 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $380.19 Typical High $724.44 | Professional | None | $60.26 | $380.19 | $724.44 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $5,248.07 Typical High $12,302.69 | Facility | None | $2,137.96 | $5,248.07 | $12,302.69 |
United Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $346.74 | Professional | None | $128.82 | $218.78 | $346.74 |
Wellpoint Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $112.20 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $23.44 | $25.70 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $117.49 Typical High $128.82 | Professional | 52 · Reduced service | $112.20 | $117.49 | $128.82 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $46.77 Typical High $51.29 | Professional | 53 · Discontinued | $44.67 | $46.77 | $51.29 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $169.82 | $177.83 | $194.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $35.48 | $38.90 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.44 Typical High $25.70 | Professional | 56 · Pre-op care only | $22.39 | $23.44 | $25.70 |
Where Texas sits
The same service costs 88.6 times more in Wyoming than in Montana. 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.
Physician feeFacility fee
WY $59,374MT $670
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.