How much rates vary
Facilitymedian $741 · 10th to 90th $135 to $3,715Professionalmedian $56 · 10th to 90th $20 to $468
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 $20.89 Median $22.39 Typical High $1,096.48 | Professional | None | $20.89 | $22.39 | $1,096.48 |
BCBS Texas Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Christus Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $1,479.11 | Facility | None | $141.25 | $194.98 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $57.54 | Professional | None | $39.81 | $54.95 | $57.54 |
Lucent Health Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $467.74 | Professional | None | $407.38 | $467.74 | $467.74 |
Moda Health Setting Facility Modifier None Typical Low $30.90 Median $1,778.28 Typical High $5,495.41 | Facility | None | $30.90 | $1,778.28 | $5,495.41 |
Moda Health Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $31.62 | Professional | None | $20.89 | $21.38 | $31.62 |
Providence Setting Facility Modifier None Typical Low $60.26 Median $223.87 Typical High $3,801.89 | Facility | None | $60.26 | $223.87 | $3,801.89 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $54.95 Typical High $58.88 | Professional | None | $39.81 | $54.95 | $58.88 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $39.81 | Professional | None | $18.20 | $25.70 | $39.81 |
Wellpoint Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
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 $10.47 Median $10.72 Typical High $13.80 | Professional | 52 · Reduced service | $10.47 | $10.72 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.27 Typical High $5.62 | Professional | 53 · Discontinued | $4.17 | $4.27 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.85 Typical High $20.89 | Professional | 54 · Surgery only | $15.49 | $15.85 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $4.17 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.75 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.72 Typical High $13.49 | Professional | 52 · Reduced service | $10.47 | $10.72 | $13.49 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.27 Typical High $5.50 | Professional | 53 · Discontinued | $4.17 | $4.27 | $5.50 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $15.49 Median $15.85 Typical High $20.42 | Professional | 54 · Surgery only | $15.49 | $15.85 | $20.42 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $4.07 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $4.07 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.14 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.09 | $2.14 | $2.69 |
Where Texas sits
The same service costs 9.1 times more in Tennessee than in Maine. 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· 2nd of 51
$204
TN $288ME $31.62
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.