How much rates vary
Facilitymedian $646 · 10th to 90th $129 to $3,715Professionalmedian $148 · 10th to 90th $29 to $302
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 $79.43 Median $190.55 Typical High $223.87 | Professional | None | $79.43 | $190.55 | $223.87 |
BCBS Texas Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $1,258.93 | Facility | None | $128.82 | $208.93 | $1,258.93 |
BCBS Texas Setting Professional Modifier None Typical Low $74.13 Median $169.82 Typical High $239.88 | Professional | None | $74.13 | $169.82 | $239.88 |
Christus Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $199.53 Typical High $2,691.53 | Facility | None | $144.54 | $199.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $263.03 | Professional | None | $87.10 | $151.36 | $263.03 |
Lucent Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,698.24 | $1,698.24 |
Moda Health Setting Facility Modifier None Typical Low $107.15 Median $1,258.93 Typical High $5,248.07 | Facility | None | $107.15 | $1,258.93 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $218.78 | Professional | None | $79.43 | $181.97 | $218.78 |
Molina Setting Professional Modifier None Typical Low $23.99 Median $131.83 Typical High $177.83 | Professional | None | $23.99 | $131.83 | $177.83 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $6,309.57 | Facility | None | $144.54 | $234.42 | $6,309.57 |
Providence Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $263.03 | Professional | None | $87.10 | $151.36 | $263.03 |
United Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $3,801.89 | Facility | None | $616.60 | $1,995.26 | $3,801.89 |
United Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $245.47 | Professional | None | $69.18 | $144.54 | $245.47 |
Wellpoint Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $39.81 Median $91.20 Typical High $109.65 | Professional | 52 · Reduced service | $39.81 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $37.15 Typical High $43.65 | Professional | 53 · Discontinued | $15.85 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $58.88 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $11.75 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $18.62 Typical High $21.88 | Professional | 56 · Pre-op care only | $7.94 | $18.62 | $21.88 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $39.81 | $91.20 | $107.15 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $15.85 | $36.31 | $43.65 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $58.88 | $134.90 | $162.18 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $11.75 | $26.92 | $32.36 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $18.20 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.94 | $18.20 | $21.38 |
Where Texas sits
The same service costs 3.7 times more in Alaska 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· 43rd of 51
$151
AK $355MD $95.50
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.