How much rates vary
Facilitymedian $3,162 · 10th to 90th $977 to $8,318Professionalmedian $5,129 · 10th to 90th $3,388 to $35,481
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 $1,122.02 Median $3,890.45 Typical High $9,120.11 | Facility | None | $1,122.02 | $3,890.45 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,677.35 | Professional | None | $3,715.35 | $4,073.80 | $4,677.35 |
BCBS Texas Setting Facility Modifier None Typical Low $1,905.46 Median $3,715.35 Typical High $8,709.64 | Facility | None | $1,905.46 | $3,715.35 | $8,709.64 |
BCBS Texas Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
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 $4,073.80 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,073.80 | $4,786.30 | $5,754.40 |
Lucent Health Setting Professional Modifier None Typical Low $30,902.95 Median $35,481.34 Typical High $35,481.34 | Professional | None | $30,902.95 | $35,481.34 | $35,481.34 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $3,715.35 Typical High $6,918.31 | Facility | None | $977.24 | $3,715.35 | $6,918.31 |
Moda Health Setting Professional Modifier None Typical Low $3,715.35 Median $4,073.80 Typical High $4,677.35 | Professional | None | $3,715.35 | $4,073.80 | $4,677.35 |
Providence Setting Facility Modifier None Typical Low $758.58 Median $2,290.87 Typical High $3,630.78 | Facility | None | $758.58 | $2,290.87 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,754.40 | Professional | None | $4,073.80 | $4,786.30 | $5,754.40 |
United Setting Facility Modifier None Typical Low $407.38 Median $2,137.96 Typical High $8,912.51 | Facility | None | $407.38 | $2,137.96 | $8,912.51 |
United Setting Professional Modifier None Typical Low $3,090.30 Median $4,265.80 Typical High $6,456.54 | Professional | None | $3,090.30 | $4,265.80 | $6,456.54 |
Wellpoint Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $1,862.09 Median $1,995.26 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,862.09 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | 53 · Discontinued | $741.31 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,019.95 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,754.23 | $3,019.95 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 55 · Aftercare only | $549.54 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 56 · Pre-op care only | $371.54 | $407.38 | $467.74 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $1,862.09 Median $1,995.26 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,862.09 | $1,995.26 | $2,344.23 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $812.83 Typical High $933.25 | Professional | 53 · Discontinued | $741.31 | $812.83 | $933.25 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $3,019.95 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,754.23 | $3,019.95 | $3,548.13 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 55 · Aftercare only | $549.54 | $602.56 | $707.95 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $407.38 Typical High $467.74 | Professional | 56 · Pre-op care only | $371.54 | $407.38 | $467.74 |
Where Texas sits
The same service costs 4.4 times more in Alaska than in Arkansas. 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· 30th of 51
$4,365
AK $14,125AR $3,236
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.