How much rates vary
Facilitymedian $1,778 · 10th to 90th $135 to $4,467Professionalmedian $100 · 10th to 90th $18 to $912
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 $72.44 Median $100.00 Typical High $123.03 | Professional | None | $72.44 | $100.00 | $123.03 |
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 $74.13 Median $114.82 Typical High $302.00 | Professional | None | $74.13 | $114.82 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $162.18 | Professional | None | $81.28 | $109.65 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | None | $912.01 | $912.01 | $954.99 |
Moda Health Setting Facility Modifier None Typical Low $109.65 Median $1,698.24 Typical High $5,248.07 | Facility | None | $109.65 | $1,698.24 | $5,248.07 |
Moda Health Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $123.03 | Professional | None | $72.44 | $100.00 | $123.03 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $87.10 Typical High $107.15 | Professional | None | $14.79 | $87.10 | $107.15 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $120.23 Typical High $165.96 | Facility | None | $77.62 | $120.23 | $165.96 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $158.49 | Professional | None | $81.28 | $109.65 | $158.49 |
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 $70.79 Median $97.72 Typical High $144.54 | Professional | None | $70.79 | $97.72 | $144.54 |
Wellpoint Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $36.31 Median $48.98 Typical High $61.66 | Professional | 52 · Reduced service | $36.31 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.50 Typical High $24.55 | Professional | 53 · Discontinued | $14.45 | $19.50 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $72.44 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $12.30 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $48.98 Typical High $61.66 | Professional | 52 · Reduced service | $36.31 | $48.98 | $61.66 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $19.50 Typical High $24.55 | Professional | 53 · Discontinued | $14.45 | $19.50 | $24.55 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $54.95 | $74.13 | $91.20 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $10.96 | $14.79 | $18.20 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.77 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.24 | $9.77 | $12.30 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Florida. 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· 44th of 51
$102
AK $324FL $85.11
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.