How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,072 to $7,762Professionalmedian $631 · 10th to 90th $148 to $3,890
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 $851.14 Median $2,754.23 Typical High $6,918.31 | Facility | None | $851.14 | $2,754.23 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $1,202.26 | Professional | None | $602.56 | $616.60 | $1,202.26 |
BCBS Texas Setting Facility Modifier None Typical Low $3,235.94 Median $5,754.40 Typical High $11,220.18 | Facility | None | $3,235.94 | $5,754.40 | $11,220.18 |
BCBS Texas Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Christus Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,137.96 Typical High $2,884.03 | Facility | None | $758.58 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $446.68 | Professional | None | $199.53 | $208.93 | $446.68 |
Lucent Health Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Moda Health Setting Facility Modifier None Typical Low $616.60 Median $2,238.72 Typical High $6,025.60 | Facility | None | $616.60 | $2,238.72 | $6,025.60 |
Moda Health Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $794.33 | Professional | None | $602.56 | $616.60 | $794.33 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $2,137.96 Typical High $2,884.03 | Facility | None | $630.96 | $2,137.96 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $446.68 | Professional | None | $199.53 | $208.93 | $446.68 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,258.93 | $3,311.31 | $6,760.83 |
United Setting Professional Modifier None Typical Low $501.19 Median $707.95 Typical High $1,096.48 | Professional | None | $501.19 | $707.95 | $1,096.48 |
Wellpoint Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $295.12 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $295.12 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $123.03 Typical High $147.91 | Professional | 53 · Discontinued | $117.49 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $446.68 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $61.66 Typical High $74.13 | Professional | 56 · Pre-op care only | $58.88 | $61.66 | $74.13 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $309.03 | $371.54 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $123.03 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $123.03 | $147.91 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $467.74 Typical High $549.54 | Professional | 54 · Surgery only | $457.09 | $467.74 | $549.54 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $93.33 | $112.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $61.66 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $61.66 | $74.13 |
Where Texas sits
The same service costs 53.7 times more in Alaska than in New York. 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· 3rd of 51
$1,622
AK $2,692NY $50.12
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.