How much rates vary
Facilitymedian $1,738 · 10th to 90th $166 to $4,467Professionalmedian $132 · 10th to 90th $26 to $1,995
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 $575.44 Median $2,238.72 Typical High $6,918.31 | Facility | None | $575.44 | $2,238.72 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $181.97 | Professional | None | $60.26 | $138.04 | $181.97 |
BCBS Texas Setting Facility Modifier None Typical Low $1,949.84 Median $4,073.80 Typical High $4,073.80 | Facility | None | $1,949.84 | $4,073.80 | $4,073.80 |
BCBS Texas Setting Professional Modifier None Typical Low $57.54 Median $138.04 Typical High $223.87 | Professional | None | $57.54 | $138.04 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $208.93 | Professional | None | $64.57 | $131.83 | $208.93 |
Lucent Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,090.30 Typical High $3,090.30 | Professional | None | $1,995.26 | $3,090.30 | $3,090.30 |
Moda Health Setting Facility Modifier None Typical Low $95.50 Median $1,584.89 Typical High $5,248.07 | Facility | None | $95.50 | $1,584.89 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $181.97 | Professional | None | $60.26 | $138.04 | $181.97 |
Molina Setting Professional Modifier None Typical Low $19.95 Median $114.82 Typical High $144.54 | Professional | None | $19.95 | $114.82 | $144.54 |
Providence Setting Facility Modifier None Typical Low $61.66 Median $162.18 Typical High $302.00 | Facility | None | $61.66 | $162.18 | $302.00 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $208.93 | Professional | None | $64.57 | $131.83 | $208.93 |
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 $56.23 Median $114.82 Typical High $213.80 | Professional | None | $56.23 | $114.82 | $213.80 |
Wellpoint Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $29.51 Median $63.10 Typical High $89.13 | Professional | 52 · Reduced service | $29.51 | $63.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $12.02 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $93.33 Typical High $134.90 | Professional | 54 · Surgery only | $44.67 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $8.91 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $13.80 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.03 | $13.80 | $17.78 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $69.18 Typical High $89.13 | Professional | 52 · Reduced service | $29.51 | $69.18 | $89.13 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $27.54 Typical High $35.48 | Professional | 53 · Discontinued | $12.02 | $27.54 | $35.48 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $102.33 Typical High $134.90 | Professional | 54 · Surgery only | $44.67 | $102.33 | $134.90 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $20.89 Typical High $26.92 | Professional | 55 · Aftercare only | $8.91 | $20.89 | $26.92 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $13.80 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.03 | $13.80 | $17.78 |
Where Texas sits
The same service costs 3.7 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· 40th of 51
$132
WI $302MD $81.28
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.