How much rates vary
Facilitymedian $288 · 10th to 90th $66 to $3,631Professionalmedian $76 · 10th to 90th $17 to $141
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 $79.43 Median $3,715.35 Typical High $9,120.11 | Facility | None | $79.43 | $3,715.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $97.72 | Professional | None | $38.90 | $70.79 | $97.72 |
BCBS Texas Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $602.56 | Facility | None | $102.33 | $186.21 | $602.56 |
BCBS Texas Setting Professional Modifier None Typical Low $38.02 Median $70.79 Typical High $141.25 | Professional | None | $38.02 | $70.79 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $812.83 | Facility | None | $50.12 | $66.07 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $74.13 Typical High $107.15 | Professional | None | $41.69 | $74.13 | $107.15 |
Lucent Health Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Moda Health Setting Facility Modifier None Typical Low $37.15 Median $707.95 Typical High $5,248.07 | Facility | None | $37.15 | $707.95 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $100.00 | Professional | None | $38.90 | $70.79 | $100.00 |
Molina Setting Professional Modifier None Typical Low $14.45 Median $79.43 Typical High $109.65 | Professional | None | $14.45 | $79.43 | $109.65 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $66.07 Typical High $338.84 | Facility | None | $38.90 | $66.07 | $338.84 |
Providence Setting Professional Modifier None Typical Low $42.66 Median $74.13 Typical High $109.65 | Professional | None | $42.66 | $74.13 | $109.65 |
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 $34.67 Median $58.88 Typical High $104.71 | Professional | None | $34.67 | $58.88 | $104.71 |
Wellpoint Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $19.50 Median $34.67 Typical High $39.81 | Professional | 52 · Reduced service | $19.50 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $7.76 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $51.29 Typical High $60.26 | Professional | 54 · Surgery only | $28.84 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.23 Typical High $12.02 | Professional | 55 · Aftercare only | $5.75 | $10.23 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $7.94 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $34.67 Typical High $39.81 | Professional | 52 · Reduced service | $19.50 | $34.67 | $39.81 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $13.80 Typical High $15.85 | Professional | 53 · Discontinued | $7.76 | $13.80 | $15.85 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $51.29 Typical High $58.88 | Professional | 54 · Surgery only | $28.84 | $51.29 | $58.88 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.23 Typical High $11.75 | Professional | 55 · Aftercare only | $5.75 | $10.23 | $11.75 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.89 | $6.92 | $7.94 |
Where Texas sits
The same service costs 3.4 times more in Wisconsin 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· 32nd of 51
$79.43
WI $209KY $61.66
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.