How much rates vary
Facilitymedian $1,096 · 10th to 90th $575 to $4,266Professionalmedian $141 · 10th to 90th $102 to $1,023
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 $660.69 Median $2,398.83 Typical High $6,918.31 | Facility | None | $660.69 | $2,398.83 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $141.25 | Professional | None | $117.49 | $125.89 | $141.25 |
BCBS Texas Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $5,011.87 | Facility | None | $537.03 | $1,000.00 | $5,011.87 |
BCBS Texas Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | None | $27.54 | $27.54 | $27.54 |
Christus Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $870.96 Typical High $2,290.87 | Facility | None | $630.96 | $870.96 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $190.55 | Professional | None | $104.71 | $134.90 | $190.55 |
Lucent Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | None | $870.96 | $870.96 | $1,023.29 |
Moda Health Setting Facility Modifier None Typical Low $177.83 Median $1,905.46 Typical High $5,623.41 | Facility | None | $177.83 | $1,905.46 | $5,623.41 |
Moda Health Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $134.90 | Professional | None | $117.49 | $125.89 | $134.90 |
Molina Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $34.67 | Professional | None | $24.55 | $26.92 | $34.67 |
Providence Setting Facility Modifier None Typical Low $478.63 Median $851.14 Typical High $2,398.83 | Facility | None | $478.63 | $851.14 | $2,398.83 |
Providence Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $186.21 | Professional | None | $100.00 | $134.90 | $186.21 |
United Setting Facility Modifier None Typical Low $616.60 Median $2,041.74 Typical High $3,801.89 | Facility | None | $616.60 | $2,041.74 | $3,801.89 |
United Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $181.97 | Professional | None | $95.50 | $125.89 | $181.97 |
Wellpoint Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
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 $58.88 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $58.88 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $26.92 | Professional | 53 · Discontinued | $23.44 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 54 · Surgery only | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.75 | $12.59 | $13.49 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $58.88 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $58.88 | $63.10 | $67.61 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $25.12 Typical High $26.92 | Professional | 53 · Discontinued | $23.44 | $25.12 | $26.92 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 54 · Surgery only | $89.13 | $95.50 | $102.33 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $17.78 | $19.05 | $20.42 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $11.75 | $12.59 | $13.49 |
Where Texas sits
The same service costs 6.0 times more in Alaska 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· 36th of 51
$141
AK $501KY $83.18
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.